Experience of diagnosis and treatment of traumatic bronchial rupture in children in a single clinical center

Pediatr Surg Int. 2020 Sep;36(9):1019-1025. doi: 10.1007/s00383-020-04703-2. Epub 2020 Jun 22.

Abstract

Purpose: To examine the diagnosis and treatment of traumatic bronchial rupture in children at the Children's Hospital of Chongqing Medical University, Chongqing, China.

Methods: The diagnosis and treatment of eight cases of traumatic bronchial rupture were analyzed retrospectively from January 2014 to December 2019 in our hospital.

Results: Diagnosis of the eight patients was clear after a chest CT with three-dimensional reconstruction techniques and fiberoptic bronchoscopy; six of the patients had a delay in diagnosis of at least 2 weeks. Among the patients, six had left bronchus rupture, and the other two had right bronchus rupture. All eight patients received surgery; seven patients received a bronchial end-to-end valgus anastomosis, and one received right middle lobe lobectomy. There were no deaths in this group, and all patients were cured and discharged. Follow-up was conducted for 3 months to 2 years; the patients who received surgery showed mild bronchostenosis within 2 weeks after the trauma, and the other six patients showed moderate bronchostenosis upon CT examination.

Conclusion: Being alert to bronchial rupture after trauma in children is helpful for diagnosis. Chest CT with three-dimensional reconstruction techniques and fiberoptic bronchoscopy are the most valuable diagnostic methods. The patients can show excellent results if the operation for a continuous valgus anastomosis of the posterior wall and interrupted end-to-end valgus anastomosis of the anterior wall on the ruptured side is performed in the early stage of traumatic bronchial rupture.

Keywords: Bronchial rupture; Chest trauma; Children; Diagnosis; Treatment.

MeSH terms

  • Anastomosis, Surgical
  • Bronchi / diagnostic imaging
  • Bronchi / injuries*
  • Bronchi / surgery
  • Bronchoscopy / methods*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Retrospective Studies
  • Rupture
  • Thoracic Injuries / diagnosis
  • Thoracic Injuries / surgery*
  • Tomography, X-Ray Computed
  • Wounds, Nonpenetrating / diagnosis
  • Wounds, Nonpenetrating / surgery*