鈍的外傷による右主気管支損傷,中間幹完全断裂の1救命例

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  • LACERATION OF THE RIGHT MAIN BRONCHUS AND TRANSECTION OF THE INTERMEDIATE BRONCHUS FOLLOWING A BLUNT CHEST TRAUMA-REPORT OF SUCESSFULLY MANAGED CASE-

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A 26-year-old female was caught her chest wall between a wall and an automobile at a traffic accisent, was initialy treated at another hospital and transferred to our hospital on the same day. On admission, she was extremely dyspneic. Chest roentgenograms demonstrated right-sided pneumothorax. A chest tube was inserted, without improvement in the pneumothorax or her clinical condition, and a large air leak was noted. Fiberoptic bronchoscopy revealed laceration of the right main bronchus, but the distal airway condition could not be observed due to airway hemorrhage. Urgent right posterolateral thoracotomy was performed, and in addition to laceration of the right main bronchus, complete transection of the intermediate bronchus was found. The right main bronchus and intermediate bronchus were debrided, and anastomoses were performed using interrupted absorbable sutures. Her postoperative course was satisfactory, and postoperative bronchoscopic examination revealed good healing without any stricture. The key to successful outcome in treating patients with this condition is a high level of suspicion and the early use of fberoptic bronchoscopy by careful attention to peripheral regions of bronchi.

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