Traumatic Complete Occlusion of the Left Main Bronchus Managed by Temporary Placement of a Covered Self-Expandable...

BACKGROUND Traumatic bronchial obstruction resulting from blunt or penetrating chest trauma can lead to sudden respiratory failure; its diagnosis and management can be challenging. This report describes a case of traumatic complete occlusion of the left main bronchus and left lobar atelectasis, which was managed by temporary placement of a covered self-expandable metallic stent under fiberoptic bronchoscopic guidance. CASE REPORT A 37-year-old man presented with dyspnea after blunt chest trauma. Three days after admission, bronchoscopy confirmed complete occlusion of the left main bronchus; on the same day, initial recanalization with balloon dilation and cryoablation achieved only transient patency due to rapid granulation tissue regrowth. Two weeks after admission, a temporary covered self-expandable metallic stent was successfully placed based on multidisciplinary team recommendations. Within 48 hours, clinically significant lung re-expansion was observed. At 3.5 months after admission, the stent was removed. Follow-up imaging performed on the first postoperative day confirmed sustained lung expansion and airway patency. Nine months after admission, bronchoscopic evaluation indicated that the airway injury had entered a stable phase of healing. CONCLUSIONS Temporary placement of a covered self-expandable metallic stent is a viable and effective strategy for traumatic bronchial occlusion with recalcitrant granulation tissue. This minimally invasive approach facilitated anatomical and functional lung recovery, suggesting it can serve as an alternative to major surgery in cases of traumatic bronchial obstruction.