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Combined blunt aortic and bronchial injury
Poo-Sing Wong1, Ramesh R Koirala, Chuen-Neng Lee
1Department of Cardiac, Thoracic and Vascular Surgery, National University Hospital, National University of Singapore, Singapore. surwps@nus.edu.sg
The Annals of Thoracic Surgery
|November 25, 2004
Summary
Blunt chest trauma can cause rare, simultaneous aortic and bronchial injuries. This case highlights successful endovascular aortic repair followed by surgical bronchial repair in a young man.
Area of Science:
- Cardiothoracic Surgery
- Trauma Surgery
- Vascular Surgery
Background:
- Blunt chest trauma is a significant cause of morbidity and mortality.
- Injuries to the aorta and tracheobronchial tree are uncommon but severe consequences of thoracic trauma.
- Simultaneous aortic and bronchial injuries present complex management challenges.
Observation:
- A 29-year-old male presented with left blunt chest trauma.
- Initial management included thoracic endovascular graft stenting for a proximal descending aortic intimal tear.
- Post-procedure, the patient developed progressive left lung collapse due to left bronchial disruption.
Findings:
- Bronchoscopy confirmed left bronchial disruption.
- Successful surgical repair was achieved via left thoracotomy with end-to-end anastomosis of the left bronchus.
- Review of literature identified 6 similar cases of concomitant aortic and bronchial injuries.
Implications:
- This case underscores the importance of considering combined aortic and bronchial injuries in severe thoracic trauma.
- Multidisciplinary management involving vascular and thoracic surgeons is crucial for optimal outcomes.
- Endovascular aortic repair followed by surgical bronchial reconstruction can be a viable treatment strategy.