Traumatic injury to the trachea and bronchus.
Tracheobronchial injuries are relatively uncommon, often require a degree of clinical suspicion to make the diagnosis, and usually require immediate management. The primary initial goals are twofold: stabilize the airway and define the extent and location of injury. These are often facilitated by flexible bronchoscopy, in the hands of a surgeon capable of managing these injuries. Most penetrating injuries occur in the cervical area. Most blunt injuries occur in the distal trachea or right mainstem, and are best approached by a right posterolateral thoracotomy. Choice and timing of approach are dictated by the presence and severity of associated injuries. The mainstay of intraoperative management remains a single-lumen endotracheal tube. Most injuries can be repaired by simple techniques, using interrupted sutures, but some require complex reconstructive techniques. Follow-up to detect stenosis or anastomotic technique is important, as is attention to pulmonary toilet.
Karmy-Jones
Riyad
R
Heart and Vascular Center, Southwest Washington Medical Center, Suite 300, 200 N.E. Mother Joseph Place, Vancouver, WA 98664, USA.
Wood
Douglas E
DE
D001980:Bronchi / Q000293:injuries*; D006801:Humans; D014132:Trachea / Q000293:injuries*; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D014950:Wounds, Penetrating / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*