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Ann Thorac Surg 1979;28:384-391
© 1979 The Society of Thoracic Surgeons

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Articles

Diagnosis and Management of Major Tracheobronchial Injuries

Department of Surgery and the Division of Cardiothoracic Surgery, The University of Texas Health Science Center at San Antonio and The Audie Murphy Veterans Administration Hospital at San Antonio, San Antonio, TX.

^* Address reprint requests to Dr. Grover, Division of Cardiothoracic Surgery, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78284.

From 1968 to 1978, 14 patients were treated for major tracheal or bronchial injury. Five injuries resulted from blunt trauma and nine from penetrating injury. Of the 5 patients with injury due to blunt trauma, three had avulsions of the right main bronchus from the trachea. In 2 of them, the injury was associated with stellate tears of the distal trachea and bronchus. The simple avulsion was repaired by a primary anastomosis of the right main bronchus to the distal trachea. For the other 2 patients, treatment consisted of right pneumonectomy. The remaining 2 patients in this group had complete transection of the trachea and underwent primary repair.

Of the 9 patients with a penetrating injury, 4 had lacerations of the cervical trachea which were treated with neck exploration and tracheostomy. Three patients with partial transections of the cervical or upper mediastinal trachea were treated by primary closure. The other 2 patients had gunshot wounds to the distal right lateral trachea, which were treated by right thoracotomy and primary closure. There were no deaths, and the subsequent course was generally good in all patients.

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