Bronchoplasty of Ruptured Segmental Bronchus from Penetrating Thoracic Injury

Abstract

Rupture of segmental bronchus is an uncommon injury, although the frequency of penetrating chest trauma continues to escalate. Early diagnosis and meticulous repair are essential for good chinical results in there patients. Here we report a successful management of the segmental bronchial rupture resulting from a penetrating thoracic injury. The patient is a 38 years old male who was injured while riding a motorcycle by its handle on the left chest. The initial symptoms were dyspnea and chest pain. An open wound with foreign body was visible on the anterior axillary line of the left chest. The preoperative chest x-ray revealed a hemopneumothorax, and a foreign body density in the left chest. Cardiac injury was ruled out using computed tomography of the chest. The operation was performed with a standard left posterolateral thoracotomy incision through the fifth intercostal space. There were ruptures of the anteromedial basal and superior segments of the left lower lobe with deep lung laceration. Also massive air leakage was observed through the wound sites. Injury of the major vessels and heart was not seen. The bronchoplasty with debridment of the ruptured bronchial edges and primary anastomosis with interrupted nonabsorbable sutures was performed successfully. The postoperative course was uneventful.