Original articles: General thoracicAcute injuries of the trachea and major bronchi: importance of early diagnosis
Section snippets
Material and methods
Patients with TBI treated from January 1988 through December 1997 at The University of Tennessee Medical Center at Knoxville, a level 1 trauma center, were identified through the trauma registry. The prehospital, hospital, and autopsy records were reviewed for mechanism of injury, clinical presentation, associated injuries, radiographic and bronchoscopic findings, surgical management, and outcome. Outcome was evaluated in relation to potential risk factors including mechanism of injury,
Results
All injuries involved the upper airway between the cricoid cartilage and the secondary bronchial bifurcations. Of the 20 patients treated, 10 had cervical tracheal injuries, 9 had major bronchial lacerations, and 1 had intrathoracic tracheal injury. The mean age was 27 years (range, 8 to 45 years), and there were 14 male and 6 female patients (Table 1). Nineteen patients arrived from the scene of the incident, and 1 was transferred from another facility. Ten were transported to the trauma
Comment
Tracheobronchial injuries were thought to be universally fatal before Krinitzki [6] presented the case of a human long-term survivor in 1927. Twenty years later, Kinsella and Johnsrud [7] reported the first successful primary repair of a bronchial rupture caused by blunt trauma. Since then, several series 8, 9, 10 have demonstrated that early diagnosis and primary repair of these injuries lead to the least complications and the best long-term results.
The usual principles of trauma care apply to
References (15)
- et al.
Injuries of the trachea and bronchi
Ann Thorac Surg
(1971) - et al.
Tracheal and main bronchial disruptions after blunt chest traumapresentation and management
Ann Thorac Surg
(1990) - et al.
Management of major tracheobronchial injuriesa 28-year experience
Ann Thorac Surg
(1998) - et al.
Traumatic rupture of the bronchus
J Thorac Surg
(1947) - et al.
Management of tracheobronchial disruption secondary to nonpenetrating trauma
Ann Thorac Surg
(1976) - et al.
Acute penetrating tracheal trauma
Ann Thorac Surg
(1976) - et al.
Injuries of the trachea and major bronchi
J Thorac Cardiovasc Surg
(1959)