COMPLETE TRANSECTION OF THE RIGHT MAIN BRONCHUS DUE TO BLUNT TRAUMA

Abstract

Two cases of complete transection of the right main bronchus due to traffic blunt trauma, which is seldom encountered, were transfered to our hospital. The First case, a 15-year-old woman, was dyspneic with subcutaneous emphysema at cervical region. A fiberoptic bronchoscopy was done and right bronchialinjury was diagnosed. At emergency operation, we found that the right main bronchus was transected completely and intrathoracic trachea was lacerated longitudinally about 10cm. Right pneumonecotmy and reestablishment of trachea were carried out for unstable intraoperative state and right lung contusion. However, the patient died of pneumonia on 36th POD. The second case, a 17-year-old woman, was dyspneic with subcutaneous emphysema at the anterior chest wall and comatous. Emergency thoractomy was performed and complete transection of the right main bronchus was found. We performed end to end anastomosis with interrupted 3-0 vicryl sutures. A month after reconstruction, bronchoscopy confirmed the progression of stenosis at the site of anastomosis, and the patient recieved YAG Laser photoresection. At present, 10 months after the initial trauma, the patient is asymptomatic. The significance of early diagnosis and early repair should be emphasized.