Management of right main bronchial rupture with a double lumen endotracheal tube in a patient with blunt chest trauma.
- Author:
Seung Hwan SEOL
1
;
Woon Jeong LEE
;
Seon Hee WOO
;
Dae Hui KIM
;
Jong Hui SUH
Author Information
- Publication Type:Case Report
- Keywords: Thoracic injuries; Bronchial rupture; Double-lumen endotracheal tube
- MeSH: Adolescent; Airway Obstruction; Bronchi; Bronchoscopy; Chest Tubes; Drainage; Dyspnea; Emergencies; Humans; Intubation; Neck; Pneumothorax; Positive-Pressure Respiration; Rupture*; Shock; Subcutaneous Emphysema; Thoracic Injuries; Thoracic Wall; Thorax*
- From: Clinical and Experimental Emergency Medicine 2017;4(4):250-253
- CountryRepublic of Korea
- Language:English
- Abstract: Tracheobronchial disruption is one of the most severe injuries caused by blunt chest trauma. It may cause airway obstruction and resulting life-threatening respiratory deficiency. However, the clinical presentations are variable and frequently difficult to diagnose. We report a case of a previously healthy 16-year-old man with complete right main bronchial transection sustained after a vehicular accident, who had progressive dyspnea, subcutaneous emphysema in the neck and anterior chest wall, and bilateral tension pneumothorax. Prompt chest tube drainage for suspected bilateral tension pneumothorax and a tracheal intubation were performed. Shortly after the positive pressure ventilation, severe subcutaneous emphysema developed and he was at risk for developing shock. Additional chest tubes were inserted. An emergency bronchoscopy showed rupture of the right main bronchus. After changing to a double lumen endotracheal tube, the patient’s condition improved. A surgical closure was performed and postoperative bronchoscopy showed good repair. The patient was discharged without complications.
