HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Andy C. Kiser Frank C. Detterbeck Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kiser, A. C. Articles by Detterbeck, F. C. Search for Related Content PubMed PubMed Citation Articles by Kiser, A. C. Articles by Detterbeck, F. C. Related Collections Trachea and bronchi

Ann Thorac Surg 2001;71:2059-2065
© 2001 The Society of Thoracic Surgeons

---

Current review

Blunt tracheobronchial injuries: treatment and outcomes

^a Division of Cardiothoracic Surgery, Department of Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA

Address reprint requests to Dr Detterbeck, University of North Carolina at Chapel Hill, 108 Burnett-Womack Bldg, CB 7065, Chapel Hill, NC 27599-7065
e-mail: fdetter{at}med.unc.edu

Background. Tracheobronchial injury is a recognized, yet uncommon, result of blunt trauma to the thorax. Often the diagnosis and treatment are delayed, resulting in attempted surgical repair months or even years after the injury. This report is an extensive review of the literature on tracheobronchial ruptures that examines outcomes and their association with the time from injury to diagnosis.

Methods. We reviewed all patients with blunt tracheobronchial injuries published in the literature to determine the anatomic location of the injury, mechanism of the injury, time until diagnosis and treatment, and outcome. Only patients with blunt intrathoracic tracheobronchial traumas were included.

Results. We identified 265 patients reported between 1873 and 1996. Motor vehicle accidents were the most frequent mechanism of injury (59%). The overall mortality among reported patients has declined from 36% before 1950 to 9% since 1970. The injury occurred within 2 cm of the carina in 76% of patients, and 43% occurred within the first 2 cm of the right main bronchus. The proximity of the injury to the carina had no detectable effect on mortality. Injuries on the right side were treated sooner but were associated with a higher mortality than left-sided injuries. No association was detected between delay in treatment and successful repair of the injury; ninety percent of patients undergoing treatment more than 1 year after injury were repaired successfully.

Conclusions. This review of patients with blunt tracheobronchial injuries represents the largest cohort studied to date. These data suggest an ability to repair tracheobronchial injuries successfully many months after they occur. We are also able to assess the mortality associated with the location and side of injury, examine the time from injury until diagnosis and treatment, and evaluate treatment outcome.

This article has been cited by other articles:

				A. Toker, S. Tanju, and S. Dilege Reimplantation of the Left Lung 17 Years After a Bronchial Rupture Ann. Thorac. Surg., April 1, 2008; 85(4): 1436 - 1438. [Abstract] [Full Text] [PDF]

				P. T Mihos, K. Potaris, I. Gakidis, P. M Myrianthefs, and G. J Baltopoulos Clear-Cut Complete Rupture of Origin of Right Main Bronchus Asian Cardiovasc Thorac Ann, February 1, 2008; 16(1): 65 - 67. [Abstract] [Full Text] [PDF]

				H. Ishibashi, S.-i. Ohta, M. Hirose, and T. Akimoto Blunt tracheal transection and long tear in posterior membranous trachea Eur. J. Cardiothorac. Surg., December 1, 2006; 30(6): 945 - 947. [Abstract] [Full Text] [PDF]

				M. R. Aerni, J. G. Parambil, M. S. Allen, and J. P. Utz Nontraumatic disruption of the fibrocartilaginous trachea: causes and clinical outcomes. Chest, October 1, 2006; 130(4): 1143 - 1149. [Abstract] [Full Text] [PDF]

				M. Conti, M. Pougeoise, A. Wurtz, H. Porte, F. Fourrier, P. Ramon, and C.-H. Marquette Management of postintubation tracheobronchial ruptures. Chest, August 1, 2006; 130(2): 412 - 418. [Abstract] [Full Text] [PDF]

				S. Leinung, C. Mobius, H.-S. Hofmann, R. Ott, H. Ruffert, E. Schuster, and U. Eichfeld Iatrogenic tracheobronchial ruptures - treatment and outcomes Interactive CardioVascular and Thoracic Surgery, June 1, 2006; 5(3): 303 - 306. [Abstract] [Full Text] [PDF]

				P. C. MacDougall Postoperative tracheal rupture in a patient with a difficult airway: [Rupture postoperatoire de la trachee chez un patient difficile a intuber]. Can J Anesth, April 1, 2006; 53(4): 385 - 388. [Abstract] [Full Text] [PDF]

				P.-S. Wong, R. R. Koirala, and C.-N. Lee Combined Blunt Aortic and Bronchial Injury Ann. Thorac. Surg., December 1, 2004; 78(6): 2157 - 2159. [Abstract] [Full Text] [PDF]

				V. S. Costache, C. Renaud, L. Brouchet, T. Toma, F. Le Balle, J. Berjaud, and M. Dahan Complete tracheal rupture after a failed suicide attempt Ann. Thorac. Surg., April 1, 2004; 77(4): 1422 - 1423. [Abstract] [Full Text] [PDF]

				N. R. Tai and K. D Boffard Thoracic trauma: principles of early management Trauma, April 1, 2003; 5(2): 123 - 136. [Abstract] [PDF]

				S. Reddy, P. Davierwala, P. Kumar, N. Thakur, P. Babu, and A. Tendolkar Bronchial transection resulting from trivial blunt chest trauma Ann. Thorac. Surg., June 1, 2002; 73(6): 1948 - 1949. [Abstract] [Full Text] [PDF]