Traumatic bronchial transection following blunt trauma in a teenager: A case report

Abstract

Tracheobronchial injury (TBI) is an uncommon, life-threatening chest injury, particularly in children, that can occur as a result of iatrogenic or unintentional trauma. It can induce airway obstruction and precipitate life-threatening respiratory failure. However, clinical manifestations can vary, posing challenges in establishing a diagnosis. We report an 11-year-old male presented with respiratory difficulty and neck swelling immediately after falling from a height of 15 meters. Chest examination revealed absent air entry in the right lung and decreased air entry in the left lung. A chest computed tomography (CT) scan revealed a right-sided pneumothorax and a complete transection of the right main bronchus 7mm from the carina. Bilateral thoracostomy and chest tube insertion were performed. The patient was further evaluated by fibreoptic bronchoscope, which showed a complete transection of the right main bronchus. However, due to the progression of subcutaneous emphysema and persistent pneumothorax, the patient subsequently underwent surgical repair of the bronchial damage with a successful outcome. In conclusion, this case report presents a rare clinical entity of TBI in children. Heightened clinical suspicion, prompt stabilization, and multidisciplinary care involving healthcare specialists are essential for the survival of TBI patients. Often, a tailored surgical approach is necessary for definitive repair.