Livezey Jonathan B, Jones Sayyid Caitlin E, Miller Daniel L
Department of General Surgery, Dwight D. Eisenhower Army Medical Center, Fort Eisenhower, Georgia.
Department of General Surgery, Augusta University Medical Center, Augusta, Georgia.
Ann Thorac Surg Short Rep. 2024 Jun 12;2(4):652-654. doi: 10.1016/j.atssr.2024.05.015. eCollection 2024 Dec.
Traumatic tracheobronchial tree injuries are rarely survivable. We present the case of a 31-year-old male patient who had a delayed discovery of a complete right mainstem bronchus avulsion following a motor vehicle collision. Despite initial respiratory stability, the patient rapidly deteriorated on hospital day 4. Flexible bronchoscopy was performed and demonstrated a right mainstem bronchus avulsion with endobronchial mediastinal adipose tissue partially obstructing and stabilizing the transected airway. The patient successfully underwent a right posterolateral thoracotomy with primary anastomosis of the right mainstem bronchus. High clinical suspicion for tracheobronchial injuries is required after high-speed acceleration-deceleration mechanisms resulting in blunt chest trauma.
创伤性气管支气管树损伤很少能存活。我们报告一例31岁男性患者，他在机动车碰撞后延迟发现右主支气管完全撕脱。尽管最初呼吸稳定，但患者在住院第4天迅速恶化。进行了可弯曲支气管镜检查，显示右主支气管撕脱，支气管内纵隔脂肪组织部分阻塞并稳定了横断的气道。患者成功接受了右后外侧开胸手术及右主支气管一期吻合术。在因高速加减速机制导致钝性胸部创伤后，需要对气管支气管损伤保持高度临床怀疑。
