Tracheobronchial rupture: a considerable risk for young teenagers

Tracheobronchial (TB) ruptures are ten times lower in children than in adults. Despite its rarity in the literature, we found that it is as common as in adults in our series. We investigated TB ruptures in childhood regarding age, trauma presentation, injury localization and treatment options. From...

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Bibliographic Details
Published in:International journal of pediatric otorhinolaryngology 2002-02, Vol.62 (2), p.123-128
Main Authors: Kaptanoglu, Melih, Dogan, Kasim, Nadir, Aydin, Gonlugur, Ugur, Akkurt, Ibrahim, Seyfikli, Zehra, Gunay, Ilhan
Format: Article
Language:English
Subjects:
Adolescence
Adolescent
Age Factors
Anastomosis, Surgical
Biological and medical sciences
Blunt
Bronchi - injuries
Bronchi - pathology
Bronchi - surgery
Bronchoscopy
Bronchus
Child
Child, Preschool
Female
Humans
Iatrogenic Disease
Infant
Injuries of the thorax. Foreign bodies. Diseases due to physical agents
Injury
Male
Medical sciences
Multiple trauma
Pneumonectomy
Retrospective Studies
Risk Factors
Rupture
Rupture - etiology
Rupture - pathology
Rupture - surgery
Suture Techniques
Thoracic
Thoracotomy
Trachea
Trachea - injuries
Trachea - pathology
Trachea - surgery
Trauma
Traumas. Diseases due to physical agents
Wounds, Nonpenetrating - complications
Wounds, Nonpenetrating - surgery
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Summary:Tracheobronchial (TB) ruptures are ten times lower in children than in adults. Despite its rarity in the literature, we found that it is as common as in adults in our series. We investigated TB ruptures in childhood regarding age, trauma presentation, injury localization and treatment options. From 1994 through 2001, eight children (six male, two female) were admitted to our department with TB injury. All patients were healthy prior to trauma. The average and median ages were 9.8 and 11, respectively. All patients except one (iatrogenic) were suffering from blunt thoracic trauma. There were seven main bronchial (five right, two left) and one tracheal wounds. Six of the ruptures were circumferential. Urgent ( n=6) and delayed ( n=2) thoracotomies were performed; ‘end-to-end’ anastomosis ( n=4), pneumonectomy ( n=2) and ‘primary suturing’ ( n=2) were applied. We had no mortality. Main bronchus rupture was overlooked in two patients as one of them had almost totally normal clinical appearance, and the other one had negative endoscopic findings. Both of these patients were successfully operated within 3 months. Our limited experience showed us that these kinds of injuries threaten school age population as well. False negative bronchoscopic results increase when additional injuries accompany. TB ruptures should be always taken into consideration after blunt chest trauma. Early or late repair of the lesion should be decided depending on the patient's clinical course.
ISSN:0165-5876
1872-8464
DOI:10.1016/S0165-5876(01)00600-0