Zapatero J, Flandes J, Peñalver R, Madrigal L, Lago J, Reboiras S D, Saldaña D, Muguruza I, Candelas J
Servicio de Cirugía Torácica, Hospital Ramón y Cajal, Madrid.
Arch Bronconeumol. 1996 May;32(5):222-4. doi: 10.1016/s0300-2896(15)30767-5.
Tracheobronchial ruptures represent a serious pathology difficult to diagnose at the first examination. The authors review 6 cases: four as acute types with pneumomediastinum, pneumothorax and subcutaneous emphysema with a delay in diagnosis of 3.25 days, meanwhile 2 cases were chronic forms with a delay in diagnosis of 124.5 days. Diagnosis should be performed as soon as possible based in the presence of uni or bilateral pneumothorax with pneumomediastinum being confirmed by fiber bronchoscopy. The treatment is based in the resection of the fractured fragments, followed by bronchoplasty always with reabsorbable sutures the most frequent surgical technique, meanwhile in the atelectatic forms it is not possible to perform sometimes and we must practise lung resections.
气管支气管破裂是一种严重的病理状况,在初次检查时难以诊断。作者回顾了6例病例:4例为急性类型,伴有纵隔气肿、气胸和皮下气肿,诊断延迟3.25天;同时,2例为慢性类型,诊断延迟124.5天。一旦出现单侧或双侧气胸且经纤维支气管镜证实存在纵隔气肿,应尽快进行诊断。治疗方法是切除骨折碎片,随后进行支气管成形术,最常用的手术技术是使用可吸收缝线,而对于肺不张的情况,有时无法进行支气管成形术,必须进行肺切除术。