Anaesthetic management of primary repair of complete right bronchial rupture following blunt chest trauma

Abstract

Tracheobronchial injury is a rare incidence after blunt trauma injury. Isolated complete bronchial tear is very rare. If it is not managed properly and timely, it can lead to significant morbidity and mortality. Clinical manifestations of tracheobronchial injury include persistent pneumothorax, subcutaneous emphysema, pneumomediastinum and respiratory insufficiency. Anaesthesiologists face challenges while securing the airway, controlling oxygenation, managing one-lung ventilation and maintaining anaesthesia during airway surgery. The preferred airway management technique is to intubate the healthy bronchus with a single-lumen or double-lumen endotracheal tube. We report successful anaesthetic management of complete traumatic rupture of the right main bronchus at the carina in adult male patients by using a left-sided double-lumen endotracheal tube. After induction, right thoracotomy was performed and bronchial transection was repaired successfully. Early correct diagnosis and proper repair can lead to excellent outcome.