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Middle-Lobe Bronchus Transection in Blunt Thoracic Trauma From a High-Speed Motor Vehicle Collision: A Case Report
Killen H Briones-Claudett1,2,3, Mónica H Briones-Claudett3,4, Killen H Briones-Zamora2,5
1Faculty of Medical, Health and Life Sciences, International University of Ecuador, UIDE, Quito, Ecuador.
The American Journal of Case Reports
|April 21, 2025
Summary
Blunt thoracic trauma can cause rare bronchial rupture, requiring high suspicion for early diagnosis. Prompt surgical intervention and multidisciplinary care are crucial for patient survival and recovery.
Area of Science:
- Trauma Surgery
- Thoracic Surgery
- Emergency Medicine
Background:
- Bronchial rupture is a rare but life-threatening consequence of blunt thoracic trauma.
- Early recognition and prompt intervention are critical for improving patient outcomes.
- Multidisciplinary trauma care is essential for managing complex injuries.
Purpose of the Study:
- To highlight the importance of suspecting tracheobronchial injuries in blunt thoracic trauma.
- To emphasize the diagnostic role of advanced imaging and bronchoscopy.
- To underscore the necessity of timely surgical management and a coordinated approach.
Main Methods:
- Case report of a 52-year-old male following a high-speed motor vehicle collision.
- Initial assessment included Glasgow Coma Scale (GCS) and extended focused assessment with sonography in trauma (eFAST).
- Diagnostic workup involved chest CT, exploratory laparotomy, and emergency thoracotomy.
Main Results:
- The patient presented with multiple injuries, including pneumothorax, hemoperitoneum, and liver trauma.
- Worsening respiratory status led to thoracotomy, revealing a complete transection of the middle-lobe bronchus.
- A middle lobectomy and rib fixation were performed due to bronchial injury and rib fractures.
Conclusions:
- A high index of suspicion is vital for diagnosing tracheobronchial injuries in blunt thoracic trauma.
- While eFAST is useful, CT scans and bronchoscopy are definitive for diagnosis.
- Optimal outcomes depend on prompt surgical intervention and a multidisciplinary team approach.
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