Diagnostic and therapeutic approaches in tracheobronchial rupture: analysis of 23 patients

Abstract

Background: In this article we examined diagnostic and therapeutic results of tracheobronchial ruptures which we treated. Methods: In our study the records of 23 patients (19 mates, 4 females; mean age 21.0 +/- 15.8 years; range 1 to 64 years) who were admitted to and treated in our clinic between June 1992 and October 2008 due to tracheobronchial rupture caused by trauma or iatrogenic factors were examined retrospectively. Patients were evaluated in terms of injury type, localization of lesion. diagnostic and therapeutic methods. Results: A bronchus was ruptured in 17 patients (73.9%) and trachea was ruptured in six patients (26.1%). Bronchoscopy provided the diagnosis in 91%. Computed tomography was performed in four patients (17%). Eleven of the ruptures were in the right bronchial tree (47.8%), whereas six were in the left bronchial tree (26.1%) and six were in the trachea (26.1%). While surgical therapy was performed in 17 patients (73.9%), conservative therapy was administered in six (26.1%) patients. Morbidity occurred in two (8.7%) patients and one patient died (4.3%). Conclusion: Immediate or delayed surgical treatment can be successful in rupture or complete disruption of tracheobronchial ruptures. Multitrauma patients should be surgically treated as soon as cardiopulmonary status was stabilized. If there is a suspicion of tracheobronchial trauma. bronchoscopy should not be spared. If suspicion continues, repetitive bronchoscopy shouldn't be avoided.