Complex bronchial ruptures in blunt thoracic trauma: management and outcome
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CASE REPORT
Complex bronchial ruptures in blunt thoracic trauma: management and outcome Hassan Jamal Eddine 1 & Walid Abu Arab 1,2
&
Ahmed AlSaleh 3 & Haisam Saad 1 & Salah Termos 3
Received: 3 March 2020 / Revised: 3 August 2020 / Accepted: 6 August 2020 # Indian Association of Cardiovascular-Thoracic Surgeons 2020
Abstract Complex bronchial ruptures are rare. Primary surgical repair is the preferred procedure. The aim of this retrospective case series was to study the clinical presentation of these complex bronchial injuries and their management and outcomes. Patients with injuries to the trachea or those who had simple single bronchial rupture and isolated lobar and segmental injuries were excluded. Twenty-one patients were operated for bronchial rupture due to blunt chest trauma. Seven patients had complex bronchial injuries and had right bronchial tree injury (n = 3), left bronchial tree injury (n = 3), and rupture of both right and left main bronchi (n = 1). Fibreoptic bronchoscopy established the diagnosis in all patients. Postoperative complications included atelectasis in four patients (57%) and left recurrent laryngeal nerve paralysis (n = 1; 14.3%), and one patient required tracheostomy (14.3%). All patients had follow-up bronchoscopy 2 months later, which showed no stenosis or scar formation in any of the patients. We concluded that primary repair of complex bronchial injuries, with preservation of the normal functioning lung, is the preferred option as it carries favorable immediate- and long-term results. Keywords Bronchial rupture . Bronchial injuries . Blunt thoracic trauma . Bronchial repair
Introduction Bronchial injuries are rare. Although it was reported that their incidence declined following introduction of safety belts and airbags [1], they have become more common due to the increasing use of high-speed transportation [2]. The complex bronchial injuries are sometimes difficult to diagnose and treat. They usually require a highly specialized thoracic surgery center that manages such rare injuries. The priority in the Meeting Presentation The preliminary work was presented as an oral presentation at the annual meeting of the World Society of Cardiovascular and Thoracic Surgery (WSCTS2015) that was held at Edinburgh, Scotland, during 19–22 September 2015. The abstract including the preliminary work was published on-line by the Journal of Cardiovascular Surgery under the title (Management of Complex Bronchial Ruptures in Blunt Trauma). * Walid Abu Arab [email protected] 1
Thoracic Surgery Unit, Chest Disease Hospital, Kuwait City, Kuwait
2
Cardiothoracic Surgery Department, Faculty of Medicine of Alexandria, Middan Al-khartoum, Alexandria, Egypt
3
General Surgery Department, Amiri Hospital, Kuwait City, Kuwait
management of patients with these injuries is to reconstruct the airway with maximal preservation of the normal functioning lung [3]. The aim of this study is to present our experience in the diagnosis, management, and outcome of these complex bronchial injuries.
Patients
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