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Rupture of the airways after blunt chest trauma in two children
F Becmeur1, L Donato, P Horta-Geraud
1Department of Pediatric Surgery, Hôpital Hautepierre, Strasbourg, France.
Insights
Airway rupture from blunt chest trauma is rare in children. Diagnosis requires evaluating accident mechanisms and bronchoscopy, with surgery not always immediately needed.
Area of Science:
- Pediatric Surgery
- Thoracic Trauma
- Respiratory Medicine
Background:
- Blunt chest trauma can cause airway rupture, a rare but severe injury in children.
- Prompt diagnosis and management are crucial for favorable outcomes.
Observation:
- Two pediatric cases of airway rupture are presented: a 3-year-old boy with tracheal tear and a 12-year-old girl with left main bronchus tear.
- Both patients had associated injuries, highlighting the complexity of these cases.
Findings:
- Airway rupture diagnosis should consider accident mechanisms.
- Bronchoscopy is essential for lesion identification and treatment planning.
- Immediate surgery is not always required if chest X-ray shows good reexpansion and manageable air leakage.
Implications:
- This study emphasizes a conservative approach in select cases, allowing for delayed surgical intervention if necessary.
- Local airway reconstruction is a viable option even in delayed surgical scenarios.
- Understanding these rare injuries aids in optimizing pediatric trauma care.
Abstract:
Rupture of the airways after blunt chest trauma is exceptional in children. Two recent cases are reported, in a 3-year-old boy and in a 12-year-old girl. Both had longitudinal tears, of the trachea for Patient 1, and of the main left bronchus for Patient 2 with many associated lesions for this patient. Diagnosis of rupture of the airways must always be referred to the mechanisms of the accident. Bronchoscopy is mandatory, in order to define the lesions, and to guide the treatment. Immediate surgery is not always necessary if the chest roentgenogram demonstrates a good reexpansion, with a well tolerated and decreasing air leakage. Even in case of a delayed surgery, it is possible to perform a local reconstruction.