Tracheobronchial injury secondary to blunt chest trauma: Diagnosis and management

Tracheobronchial injury is an uncommon complication in blunt chest trauma. The typical clinical features include haemoptysis, dyspneoa, and air leak. Tracheobronchial injury occurs after high energy impact and is commonly associated with injuries of other vital organs. If tracheobronchial injury is...

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Bibliographic Details
Published in:Anaesthesia and intensive care 2002-04, Vol.30 (2), p.145-152
Main Authors: CHU, C. P. W, CHENT, P. P
Format: Article
Language:English
Subjects:
Biological and medical sciences
Bronchi - injuries
Humans
Injuries of the thorax. Foreign bodies. Diseases due to physical agents
Medical sciences
Thoracic Injuries - complications
Thoracic Injuries - diagnosis
Thoracic Injuries - therapy
Trachea - injuries
Traumas. Diseases due to physical agents
Wounds, Nonpenetrating - complications
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Summary:Tracheobronchial injury is an uncommon complication in blunt chest trauma. The typical clinical features include haemoptysis, dyspneoa, and air leak. Tracheobronchial injury occurs after high energy impact and is commonly associated with injuries of other vital organs. If tracheobronchial injury is undetected and left untreated, it may cause persistent air leak which can render ventilation difficult and inefficient. Diagnosis of tracheobronchial injury should be made and confirmed by flexible bronchoscopy. The essence of airway management is to bypass the lesion by means of endobronchial intubation to the healthy bronchus with a single-lumen or double-lumen endotracheal tube. Such manoeuvres can also facilitate surgical access if thoracotomy is indicated. Taking into account the size of the lesion and the resulting respiratory status, surgical reconstruction of the injured airway is often necessary. More severe injury may even require lobectomy or pneumonectomy. Late complications of untreated tracheobronchial injury include bronchial stenosis, recurrent pneumonia and bronchiectasis. Prompt diagnosis and treatment generally lead to good functional recovery.
ISSN:0310-057X
1448-0271
DOI:10.1177/0310057X0203000204