Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2023 Mar 2:7:17.
doi: 10.21037/acr-22-83. eCollection 2023.

Case report: video-assisted thoracoscopic repair of right main bronchus transection after blunt chest injury

Jakraphan Yu  1 , Sira Laohathai  1
Affiliations
Case Reports

Case report: video-assisted thoracoscopic repair of right main bronchus transection after blunt chest injury

Jakraphan Yu et al. AME Case Rep. .

Abstract

Background: Traumatic tracheobronchial injury is a rare manifestation after blunt chest injury. The current standard treatment has wide spectrum from conservative treatment to open thoracotomy with repair airway regarding to severity of the disease. However, to the best of our knowledge, no one has reported airway repair in trauma using video-assisted thoracoscopic surgery (VATS) before. Hence, we describe the successful management and repair of a transected right main bronchus using VATS.

Case description: A 43-year-old male patient presented with chest tightness after a traumatic blunt chest injury; a chest computed tomography revealed multiple rib fractures and suspected right main bronchus injury with large pneumomediastinum and subcutaneous emphysema. Although the current standard treatment is to perform open thoracotomy with tracheal repair, we performed VATS repair of right main bronchus in purpose to reduce the stress from tissue trauma and minimally invasive fashion. Emergency surgery was scheduled for injury repair, and the transected right main stem bronchus and mediastinum hematoma were intraoperatively identified. The right main bronchus was repaired using polypropylene 4-0 interrupted sutures under uniportal VATS and covered with pericardial fat pad tissue. After the surgery, the patient had no air leak from chest tube drainage and recovered well. The patient was performed diagnostic bronchoscopy to confirm the patent airway at day 3 then discharged 7 days after surgery and was doing well at a 1-month follow-up.

Conclusions: VATS repair is safe and feasible as an alternative approach to conventional thoracotomy approach in the treatment of traumatic tracheobronchial injury.

Keywords: Blunt chest trauma; case report; tracheal rupture; tracheobronchial injury; video-assisted thoracoscopic surgery (VATS).

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://acr.amegroups.com/article/view/10.21037/acr-22-83/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Chest X-ray showed evidence of pneumomediastinum and fracture rib both side.
Figure 2
Figure 2
Chest computed tomography suspected an injury of right main bronchus.
Figure 3
Figure 3
Right main bronchus complete transection.
See this image and copyright information in PMC

Comment in

References

    1. Karmy-Jones R, Wood DE. Traumatic injury to the trachea and bronchus. Thorac Surg Clin 2007;17:35-46. 10.1016/j.thorsurg.2007.03.005 - DOI - PubMed
    1. Cardillo G, Carbone L, Carleo F, et al. Tracheal lacerations after endotracheal intubation: a proposed morphological classification to guide non-surgical treatment. Eur J Cardiothorac Surg 2010;37:581-7. 10.1016/j.ejcts.2009.07.034 - DOI - PubMed
    1. Grewal HS, Dangayach NS, Ahmad U, et al. Treatment of Tracheobronchial Injuries: A Contemporary Review. Chest 2019;155:595-604. 10.1016/j.chest.2018.07.018 - DOI - PMC - PubMed
    1. Farley LS, Schlicksup KE. Tracheal Injury. Treasure Island (FL): StatPearls Publishing; 2022. - PubMed
    1. Flannery A, Daneshvar C, Dutau H, et al. The Art of Rigid Bronchoscopy and Airway Stenting. Clin Chest Med 2018;39:149-67. 10.1016/j.ccm.2017.11.011 - DOI - PubMed

Publication types