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Traumatic bronchial rupture: an unusual cause of tension pneumothorax.

Hippargi SH - Int J Emerg Med (2010)

Bottom Line: Bronchial rupture is a rare and serious complication of blunt chest trauma, which can be easily overlooked on initial evaluation in the emergency room (ER) as the focus of the attending physician is diverted to more obvious external injuries which may not be of much significance.We present one such patient referred to us as a case of unresolved right-sided pneumothorax 2 days after intercostal drainage (ICD) tube placement.

View Article: PubMed Central - PubMed

Affiliation: Department of Accident & Emergency Medicine, MMHRC, Lake Area, Melur Road, Madurai, India.

ABSTRACT
Bronchial rupture is a rare and serious complication of blunt chest trauma, which can be easily overlooked on initial evaluation in the emergency room (ER) as the focus of the attending physician is diverted to more obvious external injuries which may not be of much significance. We present one such patient referred to us as a case of unresolved right-sided pneumothorax 2 days after intercostal drainage (ICD) tube placement.

No MeSH data available.


Related in: MedlinePlus

Coronal section of CT of chest showing ruptured lateral wall of right main bronchus, collapsed lung and severe pneumothorax
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Fig2: Coronal section of CT of chest showing ruptured lateral wall of right main bronchus, collapsed lung and severe pneumothorax

Mentions: When the ICD tube was connected to low-pressure suction the patient had symptomatic relief transiently. Hence, the possibility of bronchial injury was suspected and computed tomography (CT) of the chest was done, which showed right-sided tension pneumothorax, with ICD in situ, a large tear in the right main bronchus, multiple traumatic contusions of the left lung and multiple rib fractures (Fig. 2). Cardiothoracic surgeons’ opinion was sought and they advised immediate surgical repair with a possibility of right pneumonectomy as the bronchial defect was large. It was a case with high risk and poor prognosis, as the left lung too was contused extensively. The need for emergency surgery and prognosis were explained to the patient’s relatives, but they were not willing to give consent for further management; hence, the patient was discharged against medical advice.Fig. 2


Traumatic bronchial rupture: an unusual cause of tension pneumothorax.

Hippargi SH - Int J Emerg Med (2010)

Coronal section of CT of chest showing ruptured lateral wall of right main bronchus, collapsed lung and severe pneumothorax
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2926876&req=5

Fig2: Coronal section of CT of chest showing ruptured lateral wall of right main bronchus, collapsed lung and severe pneumothorax
Mentions: When the ICD tube was connected to low-pressure suction the patient had symptomatic relief transiently. Hence, the possibility of bronchial injury was suspected and computed tomography (CT) of the chest was done, which showed right-sided tension pneumothorax, with ICD in situ, a large tear in the right main bronchus, multiple traumatic contusions of the left lung and multiple rib fractures (Fig. 2). Cardiothoracic surgeons’ opinion was sought and they advised immediate surgical repair with a possibility of right pneumonectomy as the bronchial defect was large. It was a case with high risk and poor prognosis, as the left lung too was contused extensively. The need for emergency surgery and prognosis were explained to the patient’s relatives, but they were not willing to give consent for further management; hence, the patient was discharged against medical advice.Fig. 2

Bottom Line: Bronchial rupture is a rare and serious complication of blunt chest trauma, which can be easily overlooked on initial evaluation in the emergency room (ER) as the focus of the attending physician is diverted to more obvious external injuries which may not be of much significance.We present one such patient referred to us as a case of unresolved right-sided pneumothorax 2 days after intercostal drainage (ICD) tube placement.

View Article: PubMed Central - PubMed

Affiliation: Department of Accident & Emergency Medicine, MMHRC, Lake Area, Melur Road, Madurai, India.

ABSTRACT
Bronchial rupture is a rare and serious complication of blunt chest trauma, which can be easily overlooked on initial evaluation in the emergency room (ER) as the focus of the attending physician is diverted to more obvious external injuries which may not be of much significance. We present one such patient referred to us as a case of unresolved right-sided pneumothorax 2 days after intercostal drainage (ICD) tube placement.

No MeSH data available.


Related in: MedlinePlus