Blunt Traumatic Bronchial Rupture in Patients Younger than 18 Yearsa

The aim of this study was to evaluate our results of management of bronchial rupture after blunt chest trauma in young patients. Between January 2000 and December 2007, 34 patients aged 6–18-years old were treated for bronchial rupture; 25 presented early and 9 presented late. The 21 (62%) boys and 13 (38%) girls had a mean age of 11.58 ± 2.51 years. Radiography, computed tomography, and rigid bronchoscopy were performed in stable acute cases and late-presenting cases, with rapid bronchoscopy followed by thoracotomy in urgent cases. In the patients who presented early, repair was undertaken through a right thoracotomy in 21 (84%) and via a left thoracotomy in 4 (16%). Direct suturing was carried out in all except 3 patients who needed lobectomy. Reimplantation of the main bronchus after debridement of the edges was possible in 4 (44%) of the chronic cases, and pulmonary resection was required in 5 (56%). Four (11.8%) patients died due to perioperative cardiac arrest and cerebral hypoxia with failure of resuscitation. Meticulous collaboration between the surgeon and anesthetist is important to ensure survival.