Guggiari BA, González E, Rodríguez J, Ruiz A, Massini Í

Language: Spanish
References: 15
Page: 70-74
PDF size: 1356.94 Kb.

ABSTRACT

Introduction: bronchial injuries caused by blunt chest trauma are a severe form of tracheobronchial damage that can occur as a result of blunt trauma to the thoracic region. In Mexico, a prevalence of blunt chest trauma of 73.2% and of airway injury of 0.7% was found. Objectives: to describe a clinical case of right bronchial injury due to blunt chest trauma, highlighting the clinical features, diagnosis, management and outcome. Case report: 22-year-old female patient with a history of right traumatic hemopneumothorax due to a motorbike accident, wich was initially managed conservatively with pleural drainage, wich did not initially meet criteria for exploratory thoracotomy. However, had a persistent expiratory leak and after 72 hours of monitoring without remission bronchoscopy was decided. Bronchoscopy and preoperative chest computed axial tomography (CT) scan were performed, confirming abrupt disruption of the right middle bronchus. It was decided to enter surgery to perform exploratory thoracotomy with the support of bronchoscopy. Exploratory thoracotomy was performed, showing complete amputation of the middle bronchus. Bronchoplasty was performed for the lower and middle lobe, then anastomosed to the bronchus intermedius. The bronchus was reinforced with Bioglue and Tisseel with good postoperative evolution. Control bronchoscopy was performed and 60% stenosis was found; however, segments of the middle and lower lobes had adequate air passage and no perforations. Conclusions: bronchoplasty with Bioglue and Tisseel reinforcement is also a safe and effective procedure for airway reconstruction in patients with blunt chest trauma. Accurate diagnosis is essential to improve the outcome of the management of these injuries.

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