A case of traumatic complete transection of the right main bronchus successfully treated by emergency surgery

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  • Beppu Kiichiro
    Department of Surgery, Miyazaki Prefectural Miyazaki Hospital
  • Ozono Keigo
    Department of Surgery, Miyazaki Prefectural Miyazaki Hospital
  • Sakanashi Keita
    Department of Surgery, Miyazaki Prefectural Miyazaki Hospital

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  • 緊急手術を施行し救命し得た外傷性右主気管支完全断裂の1例

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Abstract

<p>Although traumatic tracheobronchial disruption is rare, the associated mortality is high. A 15-year-old male who had been injured in a traffic accident was transferred to our hospital. On arrival, he was unconscious, but retained a normal blood pressure and spontaneous breathing. A chest radiograph showed no finding of pneumothorax, but computed tomography revealed mediastinal emphysema and obstruction of the right main bronchus, indicating bronchial disruption. Although a chest drain was inserted, no air leakage was found. Intracranial injury did not require surgery, so he underwent emergency thoracotomy. Because tracheal intubation using a double-lumen tube was unsuccessful, tracheostomy was carried out to insert a 6.5-mm spiral tube into the left main bronchus. We performed posterolateral thoracotomy, divided the azygos vein following mediastinal pleurotomy, and found complete transection of the right main bronchus. The main bronchus was repaired by end-to-end anastomosis with partial debridement of the edges. No postoperative anastomotic complication occurred. He was transferred for neurological rehabilitation due to prolonged disturbance of consciousness nineteen weeks after surgery.</p>

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