Intrathoracic tracheobronchial injuries in childhood

Trauma to the intrathoracic tracheobronchial tree is a rare but usually fatal injury. Patients with pneumothorax, subcutaneous emphysema, and a history of blunt or penetrating injury to the lower neck or chest must undergo early bronchoscopy to evaluate the lower airway. Thoracotomy should be performed as soon as the patient's condition allows an attempt at primary repair. The diagnosis is frequently missed because it is so uncommon and its symptoms may resolve after chest tube drainage of the pneumothorax. Airway stenosis or occlusion usually follows. Still, local resection of the stricture and reanastomosis frequently result in recovery of lung function. Neglected cases complicated by infection usually require lung resection.