Villarreal A, Martínez J, Portales-Castanedo A, Cruz A, Padua A, Cicero R
Hospital de Especialidades # 71 IMSS, Torreón, Coah.
Gac Med Mex. 2000 Sep-Oct;136(5):499-503.
Two cases with complete bronchial stenosis of the mainstem bronchus secondary to thoracic blunt trauma are presented. One patient had hemoneumothorax on the left side, the other one had bilateral hemothorax. Both were initially treated with drainage by thoracostomy tube with partial resolution of the thoracic bloody pleural collection. Later, the two patients developed complete atelectasis of the lung, one on the left side and the other one in the right; this later case was subject to lung decortication. The fiberopticbronchoscopy showed a complete occlusion of the mainstem bronchus in both patients. A bronchoplasty with sleeve resection of the stenotic segment was performed; the lumen of the bronchus was preserved by an end-to-end suture with separate stitchs of Vycryl 0000. Both cases remain without bronchopulmonary pathology after 4 years of follow-up of bronchoplasty. In cases of blunt thoracic trauma, it is important to consider the possibility of bronchial rupture. The importance of bronchoscopic diagnosis and surgical treatment is stressed.
本文报告两例因胸部钝性创伤继发主支气管完全性狭窄的病例。一例患者左侧血胸伴气胸，另一例双侧血胸。最初均采用胸腔闭式引流管治疗，胸腔血性胸腔积液部分消退。后来，两名患者均出现肺完全性肺不张，一例在左侧，另一例在右侧；后一例接受了胸膜剥脱术。纤维支气管镜检查显示两名患者的主支气管均完全闭塞。对狭窄段进行了袖状切除的支气管成形术；用Vycryl 0000单独缝合进行端端缝合，保留了支气管腔。支气管成形术随访4年后，两例均无支气管肺部病变。在胸部钝性创伤病例中，重要的是要考虑支气管破裂的可能性。强调了支气管镜诊断和手术治疗的重要性。
