Diagnosis and treatment of bronchial rupture from blunt thoracic trauma

Citation
Dy. Chen et al., Diagnosis and treatment of bronchial rupture from blunt thoracic trauma, CHIN MED J, 114(5), 2001, pp. 540-541
Citations number
6
Language
INGLESE
art.tipo
Article
Categorie Soggetti
General & Internal Medicine
Journal title
CHINESE MEDICAL JOURNAL
ISSN journal
0366-6999 → ACNP
Volume
114
Issue
5
Year of publication
2001
Pages
540 - 541
Database
ISI
SICI code
0366-6999(200105)114:5<540:DATOBR>2.0.ZU;2-Q
Abstract
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.