Laceration of the tracheobronchial tree due to blunt trauma; a case report

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A 31-year-old man sustained a closed thoracic injury when he was thrown from his motor bike. Rupture of the tracheobronchial tree was suspected because of the presence of bilateral pneumothorax, deep cervical emphysema, mediastinal emphysema and hypoxia. Bronchoscopy in the emergency room revealed a linear tear of the membranous portion from the lower trachea to the right bronchus. There were also fractures of the right fifth rib and left carpal and metacarpal bones. A right standard thoracotomy performed five hours after the accident revealed an extensive linear laceration of the membraneous portion of the lower trachea, right main bronchus and the right upper lobe bronchus. The laceration was repaired with 14 interrupted sutures. No other injuries were found in the thorax. Postoperative bronchoscopy demonstrated neither stenosis nor granulation in the tracheobronchial tree. He was discharged one month after the operation. This patient's history emphasized the importance of bronchoscopy in the early diagnosis of tracheobronchial injury and in the decision for surgical intervention.
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