Surgical experience of fracture bronchus

ABSTRACT

Bronchial fractures are rare, but life threatening. Their successful diagnosis and treatment require a high level of suspicion and early surgical repair. We reviewed our experience in managing these injuries over the past 10 years. Patients who were admitted to the Cardiothoracic Surgery Department, Suez Canal University Hospital and treated for bronchial fractures from 1995 to 2005 were included in this study. Clinical presentation, diagnosis, management and outcome were reviewed. Bronchoscopy identified the location of injury as fracture of the right mainstem bronchus [n=4], fracture of the left mainstem bronchus [n=3] and fracture of the right intermediate bronchus [n=2]. All patients survived after thoracotomy and primary surgical repair except two patients who died due to associated head and intra-abdominal injuries. Bronchial fracture is an unusual complication of blunt chest trauma, and the diagnosis can be delayed unless the treating medical staff has a high index of clinical suspicion in addition to the correct interpretation of clinical and radiological findings. Where the diagnosis is suspected, bronchoscopy should be performed then, progress to thoracotomy and primary surgical repair to minimize the morbidity and mortality of such injuries