Pediatric traumatic bronchial rupture; results of early and late presentation.

Abstract

The aim of this study is to evaluate our results in management of bronchial rupture after blunt chest trauma in children either presented early or late and their prognosis. Between January 2000 and December 2007, 25 cases <18 years presented early with blunt chest trauma and underwent surgical treatment of bronchial rupture, and 9 cases presented late. This study included 34 cases with age ranging from 6 to 18 years (mean 11.58+/-2.51 years). Twenty-one of them were males (61.76%) and 13 (38.24%) were females. In early cases, we approached 21 patients (84%) through right thoracotomy and 4 cases (16%) via left thoracotomy, direct sutures of the all early cases (except 3 cases needed lobectomies) were done. Reimplantation after debridment of the edges was done in 4 cases (44.44%) in the late cases, while pulmonary resections were done in 5 cases (55.56%). Mortalities from perioperative cardiac arrest and cerebral hypoxia with failure of resuscitation occurred in 4 patients (11.76%) from all cases. We conclude that early diagnosis and repair of the bronchial rupture gives good results before suppuration of the parenchyma, which leads to pulmonary resection. Meticulous coordination between the surgeon and anaesthiologist is important to prevent mortalities. Keywords: Bronchial rupture; Children; Blunt chest trauma.