Repair of complex left main bronchial rupture

Complex left main bronchial rupture at or near the carina is extremely rare. This injury is frequently missed. The treatment requires surgical and anesthetic teams highly experienced with such complex injuries. We report the case of a 49-year-old man involved in a motor vehicle accident with a complex left main bronchus injury. He was successfully managed with primary repair

Blunt and penetrating thoracic trauma: management strategy and short-term outcome

To review our experience with blunt and penetrating chest injuries that required surgical interventions. Retrospective case series. Six general hospitals in Kuwait. One hundred fifty nine patients who underwent emergency surgery for thoracic trauma. Urgent thoracic surgical procedures [thoracotomy or sternotomy]. Pattern of injuries, indications for surgery, surgical approaches, short-term morbidity and mortality. One hundred fifty-nine patients [68 with blunt and 91 with penetrating injuries] underwent thoracotomy or sternotomy between January 1995 and December 2006. The mean age was 27 years [range: 2-70 years]. The causes of penetrating injuries were stab wounds [n = 65], gunshot wounds [n = 19] and iatrogenic [n = 7]. The causes of blunt thoracic injuries were motor vehicle accidents [n = 63] and fall from height [n = 5]. The indications for thoracotomy were hemorrhage [n = 115], airway disruption [n = 14], pericardial tamponade [n = 5], clotted hemothorax [n = 8] and diaphragmatic rupture [n = 17]. Major lung resections were performed in four patients [2.5%]. The morbidity was 10 / 159 [6%] and the mortality was 7 / 159 [4.4%]. The majority of deaths were due to adult respiratory distress syndrome [ARDS]. Prompt thoracotomy can be performed with minimal morbidity and mortality in cases of blunt and penetrating thoracic injuries. The complex pattern of such injuries requires a detailed assessment and management by a thoracic surgeon

Right-sided pericardio-diaphragmatic rupture with complete liver and partial heart herniation after blunt trauma

Rupture of the diaphragm and pericardium is an uncommon injury, most frequently caused by high velocity trauma. We present a rare case of right-sided pericardio-diaphragmatic rupture [PDR] with complete herniation of the liver which prevented the complete herniation of the heart. Diagnostic pitfalls and possible mistakes in the treatment strategy are discussed