Objective To evaluate the diagnosis and management of bronchial rupture fro
m blunt thoracic trauma.
Methods A group of 31 patients with bronchial rupture was involved. Chest r
oentgenography, tomography and bronchoscopy were performed on all patients.
The surgical technique and complications were described.
Results Diagnosis was confirmed by tomography and bronchoscopy in all the p
atients. End to end anastomosis was used in 26 patients. Four patients were
operated with total pneumonectomy. One patient was repaired with an interc
ostal muscle and rib flap with blood supply. Of the 31 patients, one died o
f adult respiratory distress syndrome after operation. Most patients had ex
cellent surgical outcomes. 81% (25/31) of the bronchial rupture were delaye
d in diagnosis and treatment. The classic symptoms and signs of bronchial r
upture included subcutaneous emphysema, dyspnea and an intermediate coma in
terval. The roentgenogram showed mediastinal emphysema, pneumothorax, "drop
lung" sign and marked radiodensity of hilum widened mediastinum.
Conclusion Bronchoscopy is a useful and accurate method to diagnose and tre
at the bronchial rupture, with which surgeons can easily locate the rupture
site during surgery. Surgical treatment could restore pulmonary function i
n most patients.