Abstract

Tracheobronchial disruption is a rare, life-threatening injury associated with severe blunt chest trauma. Most injuries occur within 2.5 cm of the main carina and more often involve the right main bronchus. We report a case of occult tracheobronchial injury located in a left subsegmental bronchus discovered with flexible bronchoscopy in a 21-year-old man who sustained chest trauma after a motorcycle accident. He presented with a pneumomediastinum, right pneumothorax, and left hemothorax requiring thoracotomy to achieve hemostasis. Several hours postoperatively he developed refractory hypoxemia despite insertion of bilateral chest tubes and increased positive pressure ventilation. Flexible bronchoscopy at the bedside revealed the aforementioned bronchial disruption. A review of the literature on tracheobronchial injury and role of flexible bronchoscopy is presented.

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