title: Complete laceration of the middle lobe bronchus caused by blunt trauma.
abstract: Bronchial ruptures due to blunt trauma are rarely encountered injuries. A previously healthy 42-year-old man fell from heights of 8 meters. A prompt chest tube-drainage for suspected right sided tension pneumothorax and a tracheal intubation were performed. Massive air leak and pneumothorax of the right lung continued. Laceration of the tracheobronchial tree was suspected. Operation was performed 20 hours after patient's arrival. The complete avulsion of the middle lobe bronchus was identified during operation, and a middle lobectomy was performed. The patient was transferred to a rehabilitation hospital on 20th post-operative day without complication. Early decision making for surgery resulted in a good outcome. When a complete atelectasis of the whole right lung and a massive air leakage continues despite appropriate chest-tube drainage in a blunt trauma patient, laceration of the tracheobronchial tree should be suspected.
authors.affiliation: Division of General Thoracic Surgery, Department of Surgery School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohtsuka
authors.forename: Taichiro
authors.initials: T
authors.lastname: Goto
authors.forename: Masaki
authors.initials: M
authors.lastname: Anraku
authors.forename: Mitsutomo
authors.initials: M
authors.lastname: Kohno
authors.forename: Yotaro
authors.initials: Y
authors.lastname: Izumi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nomori
mesh_terms: D000058:Accidental Falls; D000328:Adult; D001980:Bronchi / Q000293:injuries*; D001999:Bronchoscopy; D015505:Chest Tubes; D003422:Critical Care; D004322:Drainage / Q000295:instrumentation; D006801:Humans; D022125:Lacerations / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D055370:Lung Injury / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008297:Male; D011013:Pneumonectomy; D011030:Pneumothorax / Q000209:etiology; D011237:Predictive Value of Tests; D001261:Pulmonary Atelectasis / Q000209:etiology; D013997:Time Factors; D061665:Time-to-Treatment; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy