Traumatic tracheo-bronchial ruptures

A series of 18 ruptures of trachea or bronchi is reported. Gaseous semiology is predominant (pneumomediastinum and subcutaneous emphysema 72%, pneumothorax 67%). Haemoptysis is present in 28%. Assessment of the diagnosis and localization of the rupture was obtained through rigid bronchoscopy, early in the series, and then via fiberoptic endoscopy. Ignored cases in the early phase manifested themselves lately by atelectatic phenomena. Tracheal ruptures (5) were treated by direct repair (1/5) or tracheostomy (3/5) ; 1 died before surgery. Bronchial ruptures (13) were submitted to bronchoplastic procedures (7/13) or pulmonary resection (4/13). In 2 cases, no surgery was necessary or possible. Mortality (7/18) is linked with the importance of associated lesions, especially neurological ones.