Bronchial Rupture Caused by Blunt Chest Injury

We have surgically treated six patients with bronchial rupture caused by blunt chest injury in the past 5 years. All injuries resulted from traffic accidents, except in one patient who was hit by a crane. Clinical manifestations included chest pain (n=6), subcutaneous emphysema (n=4), and dyspnea (n=6). Roentgenographic findings were tension (n=3) or nontension (n=3) pneumothorax, subcutaneous emphysema (n=4), pneumomediastinum (n=3), deep cervical emphysema (n=5), and delayed collapse of the affected lung (n=3). Three patients had associated injuries: right clavicle and rib fractures in the first; right humeral, scapular, and multiple rib fractures and left sternoclavicular joint dislocation in the second; and left clavicle fracture in the third. These six patients all underwent immediate tube thoracostomy and then bronchoplasty. Bronchoplasty was performed within 3 days in four patients and on days 16 and 30, respectively, in the other two patients. The affected lung demonstrated full expansion in all patients immediately after bronchoplasty. Follow-up bronchoscopy showed good patency of all bronchi. [Lin M-Y, Wu M-H, Chan CS, Lai W-W, Chou N-S, Tseng Y-L: Bronchial rupture caused by blunt chest injury. Ann Emerg Med March 1995;25:412-415.].