Chest computed tomography with multiplanar reformatted images for diagnosing traumatic bronchial rupture: a case report.
BACKGROUND
Unnoticed bronchial injury during the early stage of resuscitation of multiple trauma is not rare and increases mortality and morbidity.


METHODS
Three-dimensional reconstruction of the airways using a workstation connected to a multidetector chest computed tomography (CT) scanner may change the diagnostic strategy in patients with blunt chest trauma with clinical signs evocative of bronchial rupture.


RESULTS
In this case report of a young motor biker, a complete disruption of the intermediary trunk was first misdiagnosed using standard chest helical CT and bronchoscopy. Postprocessing procedures including three-dimensional extraction of the tracheobronchial tree were determinants for establishing the diagnosis, and emergent surgical repair was successfully performed. Follow-up using CT with three-dimensional reconstructions evidenced a bronchial stenosis located at the site of the rupture.


CONCLUSIONS
The present study demonstrates the potential interest of performing three-dimensional reconstructions by extraction of the tracheal-bronchial tree in patients with severe blunt chest trauma suspected of bronchial rupture.
Le Guen
Morgan
M
Department of Anesthesiology and Critical Care Medicine, La Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, University Pierre et Marie Curie Paris-6, France. morgan.le-guen@psl.aphp.fr
Beigelman
Catherine
C
Bouhemad
Belaid
B
Wenjïe
Yang
Y
Marmion
Frederic
F
Rouby
Jean-Jacques
JJ
D000328:Adult; D001980:Bronchi / Q000293:injuries* / Q000601:surgery; D001995:Bronchography / Q000379:methods*; D001999:Bronchoscopy; D006801:Humans; D011857:Radiographic Image Interpretation, Computer-Assisted; D012421:Rupture / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome