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Published on: October 31, 2025
Pediatric traumatic bronchial rupture; results of early and late presentation
1Mansoura University, Egypt.
Insights
Early surgical repair of bronchial rupture in children following blunt chest trauma yields better outcomes than delayed treatment. Prompt intervention prevents complications and the need for pulmonary resection, improving prognosis.
Area of Science:
- Pediatric Surgery
- Thoracic Trauma
- Respiratory Medicine
Background:
- Blunt chest trauma in children can cause bronchial rupture, a severe injury.
- Management strategies vary depending on presentation time (early vs. late).
Purpose of the Study:
- To evaluate the outcomes of surgical management for bronchial rupture in pediatric patients.
- To compare results between early and late presentations of bronchial rupture.
- To analyze the prognosis associated with different treatment approaches.
Main Methods:
- Retrospective review of 34 pediatric patients (<18 years) with bronchial rupture from January 2000 to December 2007.
- Categorization into early (n=25) and late (n=9) presentation groups.
- Surgical interventions included thoracotomy, direct sutures, reimplantation, and pulmonary resections.
Main Results:
- Early presentation allowed for direct suture repair in most cases (84% via right thoracotomy).
- Late presentations more frequently required pulmonary resections (55.56%) or reimplantation (44.44%).
- Overall mortality was 11.76%, attributed to perioperative complications.
Conclusions:
- Early diagnosis and surgical repair of bronchial rupture in children significantly improve outcomes and reduce the need for lung resection.
- Timely intervention prevents parenchymal suppuration and associated complications.
- Close collaboration between surgical and anesthesia teams is crucial for minimizing perioperative mortality.
Abstract:
The aim of this study is to evaluate our results in management of bronchial rupture after blunt chest trauma in children either presented early or late and their prognosis. Between January 2000 and December 2007, 25 cases <18 years presented early with blunt chest trauma and underwent surgical treatment of bronchial rupture, and 9 cases presented late. This study included 34 cases with age ranging from 6 to 18 years (mean 11.58+/-2.51 years). Twenty-one of them were males (61.76%) and 13 (38.24%) were females. In early cases, we approached 21 patients (84%) through right thoracotomy and 4 cases (16%) via left thoracotomy, direct sutures of the all early cases (except 3 cases needed lobectomies) were done. Reimplantation after debridment of the edges was done in 4 cases (44.44%) in the late cases, while pulmonary resections were done in 5 cases (55.56%). Mortalities from perioperative cardiac arrest and cerebral hypoxia with failure of resuscitation occurred in 4 patients (11.76%) from all cases. We conclude that early diagnosis and repair of the bronchial rupture gives good results before suppuration of the parenchyma, which leads to pulmonary resection. Meticulous coordination between the surgeon and anaesthiologist is important to prevent mortalities. Keywords: Bronchial rupture; Children; Blunt chest trauma.
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