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Eur J Cardiothorac Surg 2003;23:379-383
© 2003 Elsevier Science NL

A review of 24 patients with bronchial ruptures: is delay in diagnosis more common in children?

^a Department of Thoracic and Cardiovascular Surgery, School of Medicine, Mersin University, Mersin, Turkey
^b Thoracic Surgery Department, Ataturk Center for Chest Disease and Thoracic Surgery, Ankara, Turkey

Received 17 April 2002; received in revised form 23 October 2002; accepted 4 November 2002.

^* Corresponding author. GMK Bulvar Egricam Mah., Kasim Ekenler Sit. Blok B D:14, Mersin, Turkey. Tel.: +90-324-329-31-90; fax: +90-324-327-34-54

Objective: Bronchial ruptures due to blunt chest traumas are rarely encountered injuries. Because they occur seldom in pediatric age groups, even total ruptures of bronchi can be overlooked in the absence of accompanying lesions. This condition may result in a delay of diagnosis that consequently leads to irreversible septic changes in the lungs, which make resections unavoidable. The determination of predisposing factor(s) may be valuable in predicting and prevention of such situations. Method: We reviewed the records of 24 patients with bronchial ruptures hospitalized between January 1974 and December 2001 in Atatürk Center for chest disease and chest surgery. We divided the cases as ‘early’ and ‘delayed’ and each group consisted of ‘adult (age>15 years)’ and ‘pediatric (age<15 years)’ patients. Results: On reviewing the records of these patients, we observed that 75% of the delayed cases were under the age of 11 years when they survived the thoracic trauma. Conclusion: The susceptibility of children to delays is emphasized and the possible causes are discussed in the light of world literature. Simple approaches to minimize the number of misdiagnosed pediatric cases are highlighted.

Key Words: Tracheobronchial rupture • Children • Incomplete tears • Complete tears • Bronchiectasis

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