Outcome of repair of bronchial injury in 10 patients with blunt chest trauma

• Published in: Asian cardiovascular & thoracic annals Vol. 23; no. 2; pp. 180 - 184
• Main Authors: Bagheri, Reza, Afghani, Reza, Haghi, Seyed Ziaollah, Fattahi Masoum, Seyed Hossein, Sadrizadeh, Ali
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.02.2015
• Subjects: Adolescent; Adult; Anastomosis, Surgical; Bronchi - injuries; Bronchi - surgery; Bronchography; Bronchoscopy; Debridement; Early Diagnosis; Female; Hospital Mortality; Humans; Iran; Male; Postoperative Complications - mortality; Postoperative Complications - therapy; Predictive Value of Tests; Risk Factors; Thoracic Injuries - diagnosis; Thoracic Injuries - etiology; Thoracic Injuries - mortality; Thoracic Injuries - surgery; Thoracotomy - adverse effects; Thoracotomy - mortality; Time Factors; Time-to-Treatment; Treatment Outcome; Wounds, Nonpenetrating - diagnosis; Wounds, Nonpenetrating - etiology; Wounds, Nonpenetrating - mortality; Wounds, Nonpenetrating - surgery; Young Adult; Iran; thoracotomy; Bronchial injury; anastomosis; blunt trauma; outcome
• ISSN: 0218-4923; 1816-5370
• DOI: 10.1177/0218492314545621

Background Bronchial avulsion is a serious complication of blunt chest trauma, which can be easily missed on initial presentation of a patient with multiple injuries. Missing the diagnosis may increase the risk of mortality and morbidity. Methods We evaluated the outcome of 10 patients with bronchial injury following blunt chest trauma, who underwent bronchial anastomosis in Quaem Hospital, Mashhad, Iran and Imam Khomeini Hospital, Tehran, Iran, from 2001 to 2012. There were 8 men and 2 women with a mean age of 23.1 ± 4.72 years. Associated injuries were ruled out in all cases. Demographic characteristics, anatomical location of the injury, mechanism of injury, complications of bronchial anastomosis, and one-year follow-up of the patients were studied. Results Eight patients had injury to the right main bronchus and 2 had injury to the left main bronchus. The time between surgery and diagnosis ranged from immediately to 6 months after injury. One death occurred in the operating room immediately after injury, due to asphyxia. The other 9 patients underwent successful anastomosis of the avulsed bronchus. There were 7 complications after repair, which were managed by a conservative approach. In one year of follow-up, one patient with residual stenosis underwent stent placement. Conclusion Early diagnosis of major airway injury is an important factor in successful management and a favorable outcome. With improvements in surgical technique, regular follow-up, and effective management of complications, we can expect successful bronchial repair to save the lung, even with a late diagnosis.