ABSTRACT
A young soldier was crushed between two vehicles sustaining severe injury to right side of chest leading to multiple rib fractures, tension pneumothorax, bronchopleural fistula, and later on gross surgical emphysema. Rigid bronchoscopy confirmed injury to right upper bronchus. Surgical repair and postoperative care of such a major, although rare, injury was successfully achieved in this small hospital by a team augmented by a specialist from thoracic surgery centre. The risks of transport of a major thoracic injury should be assessed against a possible definitive treatment locally. Fibreoptic or rigid bronchoscopy should be employed as early as possible in all suspected cases of major airways injury. An outreach service by a thoracic surgery centre can be life-saving