Medical and Surgical Management of Noniatrogenic Traumatic Tracheobronchial Injuries
| Autor: | A. Gómez-Caro Andrés, P. Ausín Herrero, J.A. Pérez Antón, J.L. Martín de Nicolás, E. Larrú Cabrero, F.J. Moradiellos Díez, V. Díaz-Hellín |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Bronchi Diagnosis Differential Bronchoscopy medicine Humans Thoracotomy Retrospective Studies medicine.diagnostic_test business.industry Thoracoscopy General Medicine Middle Aged Thoracic Surgical Procedures medicine.disease Tracheobronchial injury Mediastinitis Subcutaneous Emphysema Surgery Trachea Blunt trauma Mediastinal Emphysema Wounds and Injuries Female Radiography Thoracic medicine.symptom Tomography X-Ray Computed business Penetrating trauma Subcutaneous emphysema |
| Zdroj: | Archivos de Bronconeumología ((English Edition)). 41:249-254 |
| ISSN: | 1579-2129 |
| Popis: | Objective TO describe the medical and surgical management of noniatrogenic traumatic tracheobronchial injuries. Patients and methods From January 1993 to July 2004, 15 cases of traumatic tracheobronchial injury were treated in our department. The diagnosis was established by bronchoscopy and a computed tomography chest scan was performed on all patients. Surgical treatment was selected for patients with unstable vital signs, an open tracheal wound, associated esophageal lesions, progression of subcutaneous or mediastinal emphysema, mediastinitis or suspicious mediastinal secretions on imaging tests, or difficulties with mechanical ventilation due to the traumatic tracheobronchial injury. Results The mean (SD) age of the patients was 35.5 (18.9) years and 12 (80%) were male. Of the 15 cases, 13 (86.7%) had penetrating trauma and 2 (13.3%) blunt trauma. The most common location of the injury was in the bronchi (9 cases; 60%), followed by the cervical trachea (4 cases; 26.6%), followed by both the thoracic trachea and bronchi (2 cases; 13.4%). The most common initial symptom was subcutaneous emphysema, which presented in 11 (73.3%) patients. Chest (12 cases; 86.7%) and orthopedic injuries (9 cases; 60%) were the most common associated injuries. Surgery was the treatment of choice in 11 (73.3%) cases and conservative medical treatment in 4 (26.7%). An irreversible brain injury caused the death of 1 patient receiving conservative treatment. Conclusions Tracheobronchial injuries may be treated conservatively if they meet strict selection criteria. Size and location should not be used as selection criteria for surgical treatment. |
| Databáze: | OpenAIRE |
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