Successful treatment of complicated tracheobronchial rupture using primary surgical repair.
Traumatic tracheobronchial disruption is a life threatening injury in the pediatric population. The clinical presentations are variable depending on whether the peribronchial tissues remain intact. A high index of clinical suggestion and accurate interpretation of radiological findings are necessary to diagnose the injury. Delays in treatment increase the risk of death and complications. We report a 9-year-old boy who presented with subcutaneous emphysema, bilateral pneumothorax, pneumomediastinum, and respiratory failure. Bronchoscopy revealed a complex rupture of the airway over the junction of the right main upper lobar and intermediate bronchus. Emergent surgical intervention was performed via a right posterolateral thoracotomy after bilateral chest tube insertion. End-to-end anastomosis of the disrupted bronchus was completed with interrupted absorbable 4-0 vicryl without additional covering of the anastomosis with pleural or muscle flap and intra-operative bronchoscopy showed a normal anastomotic relationship after the procedure was completed. The patient was discharged in good condition 10 days after the operation. At 6 months of follow up, he had good health status and bronchoscopy showed good patency over the anastomotic region.
Wu
Ching-Yang
CY
Division of Thoracic & Cardiovascular Surgery, Chang Gung Memorial Hospital, Taipei.
Chen
Tzu-Ping
TP
Liu
Yun-Hen
YH
Ko
Po-Jen
PJ
Liu
Hui-Ping
HP
D000063:Accidents, Traffic; D001980:Bronchi / Q000293:injuries* / Q000601:surgery; D002648:Child; D006801:Humans; D008297:Male; D012421:Rupture; D013908:Thoracotomy; D014132:Trachea / Q000293:injuries* / Q000601:surgery