Bronchial injury: Difference between revisions
(Add verified PubMed references (PMIDs 35082126, 28203437)) |
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==Background== | ==Background== | ||
*Primarily due to rapid deceleration | [[File:Blausen 0865 TracheaAnatomy.png|thumb|Trachobronchial anatomy.]] | ||
[[File:Tracheobronchial rupture 3D CT 3.jpg|thumb|CT reconstruction of the trachea and bronchi showing disruption of the right main bronchus with abnormal lucency (arrow).]] | |||
*Primarily due to rapid deceleration<ref>Boutros J, et al. Multidisciplinary management of tracheobronchial injury. Eur Respir Rev. 2022 Mar 31;31(163). PMID 35082126</ref> | |||
*Most occur within 2cm of carina | *Most occur within 2cm of carina | ||
==Clinical Features== | ==Clinical Features== | ||
*[[Dyspnea]], [[hemoptysis]], subcutaneous emphysema, sternal tenderness | *[[Dyspnea]], [[hemoptysis]], subcutaneous emphysema, sternal tenderness<ref>Zhao Z, et al. Update on the diagnosis and treatment of tracheal and bronchial injury. J Thorac Dis. 2017 Jan;9(1):E50-E56. PMID 28203437</ref> | ||
*[[Pneumothorax]], [[pneumomediastinum]] | *[[Pneumothorax]], [[pneumomediastinum]] | ||
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==Evaluation== | ==Evaluation== | ||
[[File:PMC5021783 gr2.png|thumb|Coronal CT chest view demonstrating left [[pneumothorax]], extensive soft tissue emphysema, and left main bronchus disruption.]] | [[File:PMC5021783 gr2.png|thumb|Coronal CT chest view demonstrating left [[pneumothorax]], extensive [[soft tissue emphysema]], and left main bronchus disruption.]] | ||
[File:PMC5021783 gr1.png|thumb|Axial CT chest view of a patient | [[File:PMC5021783 gr1.png|thumb|Axial CT chest view of a patient with a left main bronchus injury (not shown) demonstrating left [[pneumothorax]], and soft tissue emphysema.]] | ||
==Management== | ==Management== | ||
Latest revision as of 11:00, 22 March 2026
Background
- Primarily due to rapid deceleration[1]
- Most occur within 2cm of carina
Clinical Features
- Dyspnea, hemoptysis, subcutaneous emphysema, sternal tenderness[2]
- Pneumothorax, pneumomediastinum
Differential Diagnosis
Thoracic Trauma
- Airway/Pulmonary
- Cardiac/Vascular
- Musculoskeletal
- Other
Evaluation
Coronal CT chest view demonstrating left pneumothorax, extensive soft tissue emphysema, and left main bronchus disruption.
Axial CT chest view of a patient with a left main bronchus injury (not shown) demonstrating left pneumothorax, and soft tissue emphysema.
Management
- All lacerations of the bronchi involving more than 1/3 of the circumference need surg