A CASE OF TRANSECTION OF THE LEFT MAIN BRONCHUS AFTER A BLUNT CHEST TRAUMA

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 62; no. 11; pp. 2648 - 2652
• Main Authors: MUKAEYAMA, Yasuomi, IWANAGA, Kouichirou, OOYABU, Hisanori, YASUI, Yuji
• Format: Journal Article
• Language: English
• Published: Japan Surgical Association 2001
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.62.2648

A 40-year-old woman was transferred to the hospital because of severe dyspnea, extensive subcutaneous emphysema caused by a blunt chest trauma. Her chest X-ray film showed multiple rib fractures, left clavicle fracture, bilateral pneumothorax and massive subcutaneous/mediastinal air. After bilateral thoracostomy tubes were placed and an incision of the right pectoralis major muscle sheath was made, cardiopulmonary arrest developed. Resuscitation was made successfully, but a chest X-ray film showed no improvement of lung expansion despite of positive pressure breathing and thoracic drainage. As a bronchofiberscopy revealed transection of the left main bronchus, emergency operation was performed. Through the 4th intercostal space on the clamshell incision, the transected main bronchus and longitudinally lacerated bronchial membrane were repaired with interrupted 3-0 Vicryl sutures and reinforced with a rolled piece of woven Vicryl mesh. Balloon dilatation was needed for the stenosis of anastomosis 3 weeks postoperatively. One year later, the patient is doing well, while a 3D-CT scan revealed the stenosis as before.