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Ann Thorac Surg 1982;33:32-39
© 1982 The Society of Thoracic Surgeons


Articles

Diagnosis and Long-Term Follow-up of Major Bronchial Disruptions due to Nonpenetrating Trauma

Jean Deslauriers, M.D.*, Maurice Beaulieu, M.D., Gaétan Archambault, M.D., Jacques LaForge, M.D., Raymond Bernier, M.D.

From the Division of Thoracic Surgery, Chest Medicine and Radiology, Centre de pneumologie, Hôpital Laval, Québec, PQ, Canada.

* Address reprint requests to Dr. Deslauriers, 2725, chemin Ste-Foy, Québec, PQ, Canada G1V 4G5.

From 1966 through 1978, 13 patients were treated for major bronchial disruptions due to nonpenetrating trauma. In 10 patients the diagnosis was made early, and operation was carried out in all of them. Four of the 6 patients with main bronchus avulsion had primary repair and all 4 patients with lobar rupture underwent lobectomy. One patient had a left pneumonectomy. There was 1 operative death.

In 3 patients the diagnosis was made more than a month after the injury. A bronchoplastic repair was done in every patient.

All 7 patients who had repair of a transected main bronchus were assessed 2 to 14 years after operation (average, 71/2 years). Flow-volume curves on air and air-helium were normal, indicating no major airway obstruction; this finding was confirmed by clinical and bronchoscopic examinations. Pulmonary diffusing capacity for carbon monoxide was also normal in all patients. Volume measurements by closed circuit method and by body plethysmography showed restriction in 1 patient but no major air trapping. Perfusion/ventilation scans showed homogeneous distribution of air and blood flow in the lung.




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