[Traumatic airway disruption in a child: a diagnostic challenge].
OBJECTIVE
To report a case of airway disruption in a child victim of blunt thoracic trauma due to falling off a sink.


METHODS
Descriptive case report. A 34-month old boy victim of thoracic trauma was seen at the pediatric intensive care unit of a university hospital. Plain chest radiograph, thoracic computed tomography, bronchoscopy, thoracotomy, antibiotics, hemodynamic and respiratory support were performed. Plain chest radiograph, thoracic computed tomography and bronchoscopy were performed in order to arrive at a precise diagnosis of traumatic airway disruption associated with pulmonary contusion, pneumothorax, mediastinal and subcutaneous emphysema. The patient underwent thoracotomy for surgical repair of an almost complete disruption of the left main bronchus. Antibiotics and ventilatory support contributed to a favorable outcome without medium-term sequelae.


CONCLUSIONS
Children presenting with thoracic trauma must be investigated for uncommon, but potentially lethal injuries, such as tracheobronchial disruption, particularly in cases where there is strong clinical evidence. Diagnostic workup should be optimized with plain chest radiograph and thoracic computed tomography, while bronchoscopy will confirm the definitive diagnosis.
Ventura
Andréa Maria Cordeiro
AM
Hospital Universitário, Universidade de São Paulo, São Paulo, SP. amgcordeiro@uol.com.br
Góes
Patrícia Freitas
PF
Otoch
José Pinhata
JP
Fernandes
José Carlos
JC
D001980:Bronchi / Q000293:injuries*; D002675:Child, Preschool; D006801:Humans; D008297:Male; D012120:Respiration Disorders / Q000209:etiology; D012421:Rupture / Q000175:diagnosis / Q000601:surgery