HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Velly, J. F. Articles by Couraud, L. Search for Related Content PubMed PubMed Citation Articles by Velly, J. F. Articles by Couraud, L.

European Journal of Cardio-Thoracic Surgery, Vol 5, 352-355, Copyright © 1991 by European Association for Cardio-thoracic Surgery

ARTICLES

Post traumatic tracheobronchial lesions. A follow-up study of 47 cases

JF Velly, C Martigne, JM Moreau, J Dubrez, S Kerdi and L Couraud
Thoracic Surgery Unit, Xavier Arnozan Hospital, Pessac-Bordeaux, France.

This report concerns 47 ruptures of the tracheo-bronchial tree from the tracheal origin to the division of the lobar bronchi (trachea in 30 patients, main bronchus in 11, intermediate or lobar bronchus in 6). The disruption was circumferential in 24 cases and non-circumferential in 23. Injuries resulted from crush or blunt trauma in 35 cases, from seat belt or rope strangulation in 8 cases and in 4 cases, lesions were discovered following the tracheal intubation. The main symptoms were cervico-mediastinal emphysema (39), pneumothorax (31), acute dyspnea (28) and hemoptysis (11). The diagnosis was always confirmed endoscopically. In 8 patients, management of the lesions was delayed for more than 1 week due to misdiagnosis or severe associated injuries. Thirty-eight patients underwent tracheal or bronchial surgical repair associated in 13 cases with a temporary stenting, 4 patients underwent partial or total lung resection, 2 were managed by laser therapy and the 5 others received only medical care and endoscopic survey. Four patients died (8.5%), 2 from bleeding in the bronchial tree from a pulmonary artery tear, 1 from hypertensive pneumothorax under respiratory support and the last from mediastinitis due to delayed diagnosis of an associated oesophageal wound. All 43 other survived in spite of some very critical situations. This experience confirms that technical problems of surgical repair are nowadays overcome and that prognosis of tracheobronchial ruptures mainly depends on the initial control of respiratory failure and complications. Avoiding lethal anoxia or endobronchial damage in the emergency period before referring the patient to the surgeon is essential.

This article has been cited by other articles:

				G Briassoulis, M-D Fitrolaki, E Mihailidou, and A-M Spanaki Unexpected supraglottic injury following a frontal impact motor-vehicle accident BMJ Case Reports, January 8, 2009; 2009(jan08_1): bcr2008137380 - bcr2008137380. [Full Text]

				G Briassoulis, M-D Fitrolaki, E Mihailidou, and A-M Spanaki Unexpected supraglottic injury following a frontal impact motor-vehicle accident Arch. Dis. Child., April 1, 2008; 93(4): 345 - 345. [Full Text] [PDF]

				A. Ozdulger, G. Cetin, S. E. Gulhan, S. Topcu, I. Tastepe, and S. Kaya A review of 24 patients with bronchial ruptures: is delay in diagnosis more common in children? Eur. J. Cardiothorac. Surg., March 1, 2003; 23(3): 379 - 383. [Abstract] [Full Text] [PDF]

				S. Gabor, H. Renner, H. Pinter, O. Sankin, A. Maier, F. Tomaselli, and F.M. Smolle Juttner Indications for surgery in tracheobronchial ruptures Eur. J. Cardiothorac. Surg., August 1, 2001; 20(2): 399 - 404. [Abstract] [Full Text] [PDF]

				A. Mussi, M. C. Ambrogi, A. Ribechini, M. Lucchi, F. Menoni, and C. A. Angeletti Acute major airway injuries: clinical features and management Eur. J. Cardiothorac. Surg., July 1, 2001; 20(1): 46 - 52. [Abstract] [Full Text] [PDF]

				J. Jougon, M. Ballester, E. Choukroun, J. Dubrez, G. Reboul, and J.-F. Velly Conservative treatment for postintubation tracheobronchial rupture Ann. Thorac. Surg., January 1, 2000; 69(1): 216 - 220. [Abstract] [Full Text] [PDF]

				J.-P. d’Odemont and D. O.A. Rodenstein Reply Ann. Thorac. Surg., September 1, 1999; 68(3): 1124 - 1124. [Full Text] [PDF]

				J.-P. d'Odemont, D. O. A. Rodenstein, G. Massard, and J.-M. Wihlm Iatrogenic Tracheobronchial Lacerations Ann. Thorac. Surg., April 1, 1997; 63(4): 1209 - 1210. [Full Text]

				J. L. M. de Nicolas, A. P. Gamez, F. Cruz, V. Diaz-Hellin, C. Marron, J. I. Martinez, R. Galvez, and J. Toledo Long Tracheobronchial and Esophageal Rupture After Blunt Chest Trauma: Injury by Airway Bursting Ann. Thorac. Surg., July 1, 1996; 62(1): 269 - 272. [Abstract] [Full Text]