Aldakak Mohammad Alaa, Fallouh Nawwar, Ibrahim Bassel, Ahmad Raneem, Abbas Youssef, Al Kateb Kamal
Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic.
Al-Mouwasat University Hospital, Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic.
Int J Surg Case Rep. 2025 Oct;135:111892. doi: 10.1016/j.ijscr.2025.111892. Epub 2025 Sep 6.
Tracheobronchial injuries (TBI) are rare yet potentially fatal complications of blunt chest trauma, often underdiagnosed due to nonspecific clinical manifestations.
We report the case of an 11-year-old Arab girl who developed progressive dyspnea two months after a motor vehicle accident initially managed conservatively. Imaging revealed complete atelectasis of the right lung and obstruction of the right main bronchus by granulation tissue. Bronchoscopy confirmed complete bronchial occlusion, and surgical intervention revealed a delayed bronchial transection. Successful end-to-end anastomosis restored full lung expansion and respiratory function.
This case highlights the diagnostic challenge of TBIs in children, particularly when symptoms present late. Anatomical vulnerability of the right bronchus, delayed symptom onset, and nonspecific radiologic signs may obscure early recognition. Granulation-induced bronchial obstruction, a known complication of undiagnosed TBIs, was confirmed intraoperatively.
Delayed presentation of tracheobronchial injury may lead to progressive airway obstruction due to granulation tissue. High suspicion, timely bronchoscopy, and early surgical intervention are essential to prevent irreversible lung damage and restore pulmonary function.
气管支气管损伤（TBI）是钝性胸部创伤中罕见但可能致命的并发症，常因临床表现不具特异性而诊断不足。
我们报告一例11岁阿拉伯女孩的病例，她在机动车事故后最初接受保守治疗，两个月后出现进行性呼吸困难。影像学检查显示右肺完全肺不张，右主支气管被肉芽组织阻塞。支气管镜检查证实支气管完全闭塞，手术干预发现为延迟性支气管横断。成功的端端吻合术恢复了全肺扩张和呼吸功能。
该病例突出了儿童TBI的诊断挑战，尤其是症状出现较晚时。右支气管的解剖易损性、症状延迟出现以及非特异性放射学征象可能掩盖早期识别。肉芽组织导致的支气管阻塞是未诊断TBI的已知并发症，术中得到证实。
气管支气管损伤的延迟表现可能导致因肉芽组织引起的进行性气道阻塞。高度怀疑、及时进行支气管镜检查和早期手术干预对于预防不可逆的肺损伤和恢复肺功能至关重要。
