[Tracheo-bronchial fissures from external trauma in children. Apropos of 3 cases].

The authors report three cases of tears in the tracheal or bronchial membrane in children resulting from an accidental external trauma of the trachea. Those children ranged from 3, to 5 and 10 years old. Those lesions showed a clinical gaseous syndrome associated with mediastinal and subcutaneous emphysema, in one of these cases complicated by unilateral pneumothorax and pneumomediastinum. After a symptomatic resuscitation, tracheobronchial endoscopy gives evidence each time of a crack of the posterior face of the trachea = cervix trachea in one case, end of the thorax trachea in the two other cases. Among them one was injured at the stem bronchi. These tracheobronchial lesions were treated nonoperatively and had a post-operative course uncomplicated. The author's attitude--except in case of extreme urgency--in front of a severe, isolated cervix thorax contusion in children, is to give systematically the indication for tracheobronchial endoscopy, in the view of knowing whether there is a tracheobronchial lesion or not and, if so, to five precisions about its location, its anatomic size, and its type (tear, fracture, disruption). An endoscopy performed immediately after cardiorespiratory rebalancing imposes the therapeutic conduct to be adopted, which is not always operative. Such is the case for the authors, especially in the case of children for whom the diagnosis of tracheobronchial lesion is sure, and in whom the stability of the vital signs are doubtless. In such cases, one is imposed not to operate.(ABSTRACT TRUNCATED AT 250 WORDS)