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Iatrogenic tracheobronchial rupture.

Paraschiv M - J Med Life (2014)

Bottom Line: Iatrogenic tracheobronchial ruptures most frequently occur during tracheal intubation, but they can also be produced during tracheobronchial endoscopy or thoracic surgery.There are also less symptomatic presentations.The therapeutic approach can be differentiated, surgical or conservative, although the criteria are not universally accepted.

View Article: PubMed Central - PubMed

Affiliation: General Surgery Clinic, "Bagdasar-Arseni" Emergency Hospital, Bucharest.

ABSTRACT
Iatrogenic tracheobronchial ruptures most frequently occur during tracheal intubation, but they can also be produced during tracheobronchial endoscopy or thoracic surgery. The clinical presentation can be brutal, with respiratory failure, cervical emphysema, pneumothorax and hemoptysis. There are also less symptomatic presentations. The diagnosis is confirmed by bronchoscopy. The therapeutic approach can be differentiated, surgical or conservative, although the criteria are not universally accepted. This article aims to review the indications and therapeutic options.

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Related in: MedlinePlus

The tracheal suture is covered with sterno-hyoid muscle, rotated on the distal insertion. Note the traction sutures on the thyroid isthmus
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Figure 6: The tracheal suture is covered with sterno-hyoid muscle, rotated on the distal insertion. Note the traction sutures on the thyroid isthmus

Mentions: The surgery of the airway lesions must respect a few principles: minimal debridement of rupture edges, mucosa to mucosa repair, viable tissue plasty of the airway suture (muscle (Fig. 6), pericardium, pleura, mediastinal fat) [32]. The suturing material is absorbable; most authors recommend a running-suture, whenever possible. In patients with a late diagnosis, the presence of mediastinitis and inflammatory changes of the tracheobronchial wall, a simple suture is not allowed. In such cases, the use of muscle pedicled flap for covering the suture line and preventing the tracheal esophageal fistula formation is mandatory.


Iatrogenic tracheobronchial rupture.

Paraschiv M - J Med Life (2014)

The tracheal suture is covered with sterno-hyoid muscle, rotated on the distal insertion. Note the traction sutures on the thyroid isthmus
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4233436&req=5

Figure 6: The tracheal suture is covered with sterno-hyoid muscle, rotated on the distal insertion. Note the traction sutures on the thyroid isthmus
Mentions: The surgery of the airway lesions must respect a few principles: minimal debridement of rupture edges, mucosa to mucosa repair, viable tissue plasty of the airway suture (muscle (Fig. 6), pericardium, pleura, mediastinal fat) [32]. The suturing material is absorbable; most authors recommend a running-suture, whenever possible. In patients with a late diagnosis, the presence of mediastinitis and inflammatory changes of the tracheobronchial wall, a simple suture is not allowed. In such cases, the use of muscle pedicled flap for covering the suture line and preventing the tracheal esophageal fistula formation is mandatory.

Bottom Line: Iatrogenic tracheobronchial ruptures most frequently occur during tracheal intubation, but they can also be produced during tracheobronchial endoscopy or thoracic surgery.There are also less symptomatic presentations.The therapeutic approach can be differentiated, surgical or conservative, although the criteria are not universally accepted.

View Article: PubMed Central - PubMed

Affiliation: General Surgery Clinic, "Bagdasar-Arseni" Emergency Hospital, Bucharest.

ABSTRACT
Iatrogenic tracheobronchial ruptures most frequently occur during tracheal intubation, but they can also be produced during tracheobronchial endoscopy or thoracic surgery. The clinical presentation can be brutal, with respiratory failure, cervical emphysema, pneumothorax and hemoptysis. There are also less symptomatic presentations. The diagnosis is confirmed by bronchoscopy. The therapeutic approach can be differentiated, surgical or conservative, although the criteria are not universally accepted. This article aims to review the indications and therapeutic options.

Show MeSH
Related in: MedlinePlus