Bi Taiyu, Duan Xiaotian
Thoracic Surgery, First Hospital of Jilin University, Changchun, China.
Department of Nursing, First Hospital of Jilin University, Changchun, China.
Front Med (Lausanne). 2024 Jul 25;11:1434772. doi: 10.3389/fmed.2024.1434772. eCollection 2024.
Bronchial injury is rare in blunt chest trauma, but can be life-threatening. The symptoms of patients with complete bronchial rupture are typical, and most of them are diagnosed in a timely manner and treated with surgery. However, for those with partial rupture of the bronchus, the symptoms are mild, the imaging results are negative, the possibility of delayed diagnosis is high, and serious complications can occur. Early diagnosis and treatment are key to treating this disease.
We report a 52-year-old woman with mild mediastinal emphysema after blunt chest trauma. Left whole-lung atelectasis appeared after a period of conservative treatment. Bronchoscopy revealed injury of the left main bronchus, and surgery was performed. The patient's lungs recovered well after surgery. CT (Computed tomography) examination during follow-up revealed that the structure of the left main bronchus was intact and unobstructed. The left lung was well recovered.
For patients with mild symptoms of blunt chest trauma, mediastinal emphysema and subcutaneous emphysema; no pleural effusion or pneumothorax; and a negative chest CT, laryngoscopy or bronchoscopy should be performed in a timely manner to ensure the stability of the respiratory and circulatory system and confirm whether there is tracheobronchial injury. Surgical treatment should be performed in a timely manner after localization and diagnosis.
支气管损伤在钝性胸部创伤中较为罕见,但可能危及生命。完全性支气管破裂患者的症状典型,大多能及时诊断并接受手术治疗。然而,对于支气管部分破裂的患者,症状较轻,影像学检查结果为阴性,延迟诊断的可能性高,且可能发生严重并发症。早期诊断和治疗是该病治疗的关键。
我们报告一名52岁女性,钝性胸部创伤后出现轻度纵隔气肿。经过一段时间的保守治疗后出现左全肺不张。支气管镜检查显示左主支气管损伤,遂行手术治疗。术后患者肺部恢复良好。随访期间的CT(计算机断层扫描)检查显示左主支气管结构完整、通畅。左肺恢复良好。
对于钝性胸部创伤症状较轻、有纵隔气肿和皮下气肿、无胸腔积液或气胸且胸部CT检查阴性的患者,应及时进行喉镜或支气管镜检查,以确保呼吸和循环系统稳定,并确认是否存在气管支气管损伤。定位和诊断后应及时进行手术治疗。