Abstract

Trauma to the intrathoracic tracheobronchial tree is a rare, but usually fatal, injury in childhood (l), and it can result from severe blunt thoracic trauma to the upper part of the chest. When a bronchopleural fistula (BPF) in a child is associated with massive air leakage and tension pneumothorax, immediate thoracotomy for surgical correction of the airway disruption may be lifesaving (2). However, emergency thoracotomy can be difficult in a patient who is hypoxic and hypercarbic due to a lack of adequate ventilation caused by the same tracheobronchial injury. We present an extremely serious case of BPF in which one of the large bronchi was torn and where ventilation was made possible only by the use of highfrequency positive pressure ventilation (HFPPV).

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