Tracheobronchial injuries in chest trauma: a 17-year experience

Saad, Roberto; Gonçalves, Roberto Calderón; Dorgan, Vicente; Perlingeiro, Jacqueline Arantes Giannini; Rivaben, Jorge Henrique; Botter, Marcio; Assef, José Cesar

doi:10.1590/0100-69912017002014

Cited by 7 publications

(5 citation statements)

References 24 publications

(55 reference statements)

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“…In our study, the age ranged from 8 to 43 years old with a mean age of 22.3 ± 0.8 and 11 patients (39.3%) were under 18 years old. Similar results were reported by Balci et al [8] and Saad et al [7] as they had a mean age of 22.3 years (range 4-53) and 26 years (range 17-38), respectively.…”

Section: Discussionsupporting

confidence: 89%

“…Approximate figures were reported by many authors such as Richardson [3], Scaglione et al, [4], and Koletsis et al [5] who had found, respectively, that 76.7%, 67%, and 66.7% of injuries were due to blunt trauma. However, few authors reported their cases to be caused mainly by penetrating trauma such as Fatimi et al [6] and Saad et al [7]. We think that the accuracy of these figures was biased by the small sample size in most of the studies.…”

Section: Discussionmentioning

confidence: 97%

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Urgent surgical repair is pivotal in the management of major airway injury due to blunt trauma

2020

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Background Blunt traumatic airway injury is a life-threatening injury in which urgent management is pivotal and this would come through improving our clinical management and diagnostic tools. Our objective was to emphasize the importance of early referral and urgent surgical repair of major airway injury. Results Records of 42 patients with major airway injury out of 17,520 registered thoracic trauma cases were reviewed over the past 15 years. Twenty-eight cases documented to have major tracheobronchial injuries due to blunt trauma underwent surgical repair either urgent (21 cases) or late (7 cases). The age ranged from 8 to 43 years old with a mean age of 22.3 ± 0.8. The most common presenting symptom was shortness of breath in 22 (78.6%) cases and the most frequent sign was subcutaneous emphysema which was seen in 22 (78.6%) cases. The postoperative morbidity and mortality rates were significantly higher in the delayed repair group (p value < 0.001). Conclusion The urgent surgical repair is the treatment of choice for major airway injury which is facilitated by early recognition and referral. It is pivotal to avoid respiratory and systemic complications and related mortality.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 97%

Urgent surgical repair is pivotal in the management of major airway injury due to blunt trauma

2020

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“…The former preferentially causes lesions in the intra-thoracic trachea and main-stem bronchus, 80% of which are up to 2.5 cm from the carina, most commonly on the right side, and are considered less protected by the mediastinal structures. Uncommon causes include iatrogenic injuries, such as intubation-related trauma [7] (Fig. 3).…”

Section: Tracheobronchial Lesionsmentioning

confidence: 99%

Imaging features and differential diagnoses of non-neoplastic diffuse mediastinal diseases

et al. 2020

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Acute or chronic non-neoplastic diffuse mediastinal diseases have multiple causes, degrees of severity, and a wide range of management. Some situations require emergency care while others do not need specific treatment. Although the diagnosis may be suspected on chest X-ray, it is mainly based on CT. A delayed recognition is not uncommonly observed. Some findings may prompt the radiologist to look for specific associated injuries or lesions. This pictorial review will successively describe the various non-neoplastic causes of diffuse mediastinal diseases with their typical findings and major differentials. First, pneumomediastinum that can be provoked by extra- or intra-thoracic triggers requires the knowledge of patient’s history or recent occurrences. Absence of any usual etiological factor should raise suspicion of cocaine inhalation in young individuals. Next, acute mediastinitis may be related to post-operative complications, esophageal perforation, or contiguous spread of odontogenic or retropharyngeal infections. The former diagnosis is not an easy task in the early stage, owing to the similarities of imaging findings with those of normal post-operative appearance during the first 2–3 weeks. Finally, fibrosing mediastinitis that is linked to an excessive fibrotic reaction in the mediastinum with variable compromise of mediastinal structures, in particular vascular and airway ones. Differential diagnosis includes tumoral and inflammatory infiltrations of the mediastinum.

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“…However, in 10–20% of the patients, no specific finding is present in X-ray radiography. The “fallen lung sign” reflects the tendency of the separated lung to collapse down from the hilum and from the back to the side instead of collapsing inward as in other pneumothorax cases, and is regarded to be a pathognomonic finding in damage to the main bronchus [ 43 ]. Furthermore, airway injury should be suspected when an air bubble is detected inside the artificial airway [ 44 ].…”

Section: Diagnosismentioning

confidence: 99%

Airway management in penetrating thoracic trauma

Çakmak¹,

Cansun

Saraçoğlu³

et al. 2022

ait

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Approximately 20-25% of deaths due to trauma in the first four decades of life result from thoracic trauma [1]. Penetrating thoracic trauma is present in 33% of deaths due to thoracic trauma [2]. in a 1972 autopsy study involving 1178 trauma patients, 82% of the patients with tracheobronchial injuries died at the accident site; 30% of those who could come to the hospital also died. it was observed that 50% of these losses occurred in the first hour [3].Between 2001 and 2005, a total of 1033 tracheal injuries were reported over five years in Germany [4]. According to the US Centers for Disease Control and Prevention (CDC), while the medical costs of approximately 12 000 patients who died in 2005 due to firearm assault injury were more than $60 million, it was reported that the loss of work and productivity was 18 billion dollars. Between 2000 and 2005, the average hospital cost for adults over the age of 18 who had a penetrating injury was estimated at £7983 in the UK [5]. it was observed that mortality in thoracic trauma patients was 36% before 1950 and decreased to 9% after 1970 [6].

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Tracheobronchial injuries in chest trauma: a 17-year experience

Cited by 7 publications

References 24 publications

Urgent surgical repair is pivotal in the management of major airway injury due to blunt trauma

Urgent surgical repair is pivotal in the management of major airway injury due to blunt trauma

Imaging features and differential diagnoses of non-neoplastic diffuse mediastinal diseases

Airway management in penetrating thoracic trauma

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