Complete Disruption of the Left Main Bronchus due to Blunt Chest Trauma

Abstract

Isolated tracheobronchial disruption is an uncommon injury usually associated with severe blunt thoracic trauma. We herein report a 14 year-old female a case with avulsion of the left main bronchus occurring after blunt chest trauma due to a down fallen wall. A successful surgical repair of the totally avulsed left main bronchus was carried out. The post-operative course was uneventful with improvement in the respiratory status. The patient regained wellness within days in the in intensive care unit, and the diagnosis of traumatic rupture of the left main bronchus was approved by bonchoscopy and the computerized tomography (CT) scan of the chest. Surgical repair of the disrupted left main bronchus was accomplished 10 days from the admission and the bronchoscopic evaluation of the anastomosis and patency was achieved. The patient was discharged well with her lung fully expanded on chest X-ray. She is doing well during the follow-up period. The diagnosis and preoperative management of this uncommon post traumatic condition is discussed. We conclude that, in a patient with sustained severe blunt thoracic trauma, a high index of suspicion for trachea-bronchial disruptions must be maintained to detect these rare lesions. Skilful and early surgical treatments are required for proper management of such cases.