Case Of Bronchial Rupture Research Articles

Rupture of contralateral mainstem bronchus during uniportal video-assisted thoracoscopy surgery lobectomy and 3 successful cases of repair

BackgroundOur goal was to discuss the treatment for rupture of contralateral mainstem bronchus during uniportal video-assisted thoracoscopy surgery (uniportal VATS) lobectomy.Case presentationWe analyzed clinical data of 3 cases of rupture of contralateral mainstem bronchus during uniportal VATS. Surgical repair was performed immediately under an uniportal VATS during operation, as a result, 3 cases of bronchial rupture all were repaired successfully, and we continued to complete lobectomy and systemic lymph node dissection. Reexamination was performed after 1 week, and no fistula was found in trachea and bronchi through a fiberoptic bronchoscopy. The time range for indwelling the chest tube is 6–9 days, and the hospital stay is 8–10 days. No abnormality was observed on chest radiography when the 3 patients returned to the hospital 1 month after the operation for the second reexamination.ConclusionsInstant surgical repair is recommended to the treatment of bronchial rupture in thoracic surgery. It is safe and feasible to repair bronchial tear with uniportal VATS.

ダブルルーメンチューブにより左主気管支膜様部損傷をきたした1例

症例は52歳，女性．原発性左上葉肺癌の診断で胸腔鏡下左肺上葉切除術が予定された．35Frの左用ダブルルーメンチューブ（DLT）を用いた気管挿管操作に難渋することはなかった．術中の片肺換気は異常を認めず，バイタルサインも落ち着いていたが，肺切除後にリークテストを行ったところ縦隔より気漏があり，DLTにより左主気管支膜様部損傷が生じていることが判明した．開胸直視下に修復術が行われ，術後経過は良好であった．DLTを用いる際には，気管・気管支損傷を起こしうることを認識する必要がある．

An unusual case of bronchial rupture—pneumomediastinum appearing 7 days after blunt chest trauma

We present a case of bronchial disruption after blunt chest trauma, which is unusual because the pneumomediastinum on the chest radiograph was detected 7 days after the injury. The first day imaging methods of the thorax showed only the fractures of the first and third left rib without any complications. A computed tomography (CT) scan was done following control chest radiograph and it revealed a rupture of the left main bronchus with pleural effusion, subcutaneous emphysema and pneumomediastinum. This case shows that a finding of pneumomediastinum after blunt chest trauma should always merit further investigation of its cause, even in cases of postponed detection of pneumomediastinum and regardless of the absence of other indicators of tracheobronchial disruption. Although fiber-optic tracheobronchoscopy is considered a diagnostic golden standard, in this case, diagnosis was clearly confirmed by spiral CT scan, due to thin slices and continuous data acquisition.