Osama Saber El Dib1, Ehab Mohammed Kasem2. 1. Cardiothoracic Surgery Department, Zgazig University Hospital, Egypt u_saber@yahoo.com. 2. Cardiothoracic Surgery Department, Zgazig University Hospital, Egypt.
Abstract
OBJECTIVE: To present our experience of the management of bronchial injuries in children. METHODS: Between 2001 and 2012, we diagnosed 11 cases of bronchial injuries in children and reviewed their records. RESULTS: The age range was 3-12 years. Etiologies were passenger traffic accidents in 55%, pedestrian traffic accidents in 27%, and a fall from a height in 18%. Clinical manifestations were pneumothorax with continuous air leak in 81%, subcutaneous emphysema in 55%, and failure of lung expansion in 64%. Three (27%) cases were diagnosed late. All patients were operated on through a posterolateral thoracotomy. Main stem bronchial rupture was identified in the right side in 72% and in the left side in 28%. Bronchial repair was feasible in 7 (64%) cases, but resection was inevitable in 4 cases (3 pneumonectomies and one lobectomy). Two of the patients who required resection died; they had associated intraabdominal injuries. All survivors were discharged in stable condition without complications. CONCLUSION: Bronchial injuries in children are rare and challenging. Clinical, radiological, and bronchoscopic examinations facilitate the diagnosis. Early diagnosis and bronchial repair offers favorable results. Delayed diagnosis, lung resection, and associated injuries adversely affect the outcome.
OBJECTIVE: To present our experience of the management of bronchial injuries in children. METHODS: Between 2001 and 2012, we diagnosed 11 cases of bronchial injuries in children and reviewed their records. RESULTS: The age range was 3-12 years. Etiologies were passenger traffic accidents in 55%, pedestrian traffic accidents in 27%, and a fall from a height in 18%. Clinical manifestations were pneumothorax with continuous air leak in 81%, subcutaneous emphysema in 55%, and failure of lung expansion in 64%. Three (27%) cases were diagnosed late. All patients were operated on through a posterolateral thoracotomy. Main stem bronchial rupture was identified in the right side in 72% and in the left side in 28%. Bronchial repair was feasible in 7 (64%) cases, but resection was inevitable in 4 cases (3 pneumonectomies and one lobectomy). Two of the patients who required resection died; they had associated intraabdominal injuries. All survivors were discharged in stable condition without complications. CONCLUSION:Bronchial injuries in children are rare and challenging. Clinical, radiological, and bronchoscopic examinations facilitate the diagnosis. Early diagnosis and bronchial repair offers favorable results. Delayed diagnosis, lung resection, and associated injuries adversely affect the outcome.