Bronchial injuries: a tale of differing presentations

Bronchial disruptions are uncommon but nevertheless grievous injuries and are usually secondary to major thoracic trauma. Although many are associated with other catastrophic injuries causing early mortality, their presentations can be late and they are often difficult to diagnose. Their management is frequently challenging and the ideal course of treatment is not yet clearly defined. Here, we describe two cases of main bronchial injuries presenting to us with post-traumatic collapse lung, albeit with a widely differing post-trauma course. Both required thoracotomy followed by a resection and anastomosis of the disrupted/stenotic segment. Operative results were good with both cases showing a well-expanded lung and no postoperative anastomotic site stenosis during the period of follow-up. Our experience highlights that patients with major bronchial injuries can have varying presentations. High degree of suspicion is necessary for early diagnosis and prompt surgical treatment. Resection of the stenosed/fibrosed segment followed by anastomosis yields good results.