Abstract

This study is aimed to assess the patients, who had tracheobronchial injury and to discuss the difficulties either in diagnosis or treat - ment, between 1994 and 2001.

Records of 15 patients were investigated retrospectively. Etiology of trauma, physical findings, diagnostic measures, location of the injuries and treatment options were evaluated.

The youngest patient was 1 and the oldest one was 58 years old. The median age was 15 years. Blunt trauma was the major etio - logic factor (87%). Bronchoscopy was performed in 13 patients for diagnosis. Computerized tomography (CT) is not performed rou - tinely in blunt thoracic trauma, therefore, it was performed in 4 patients who had late atelectasis (n=2) and mediastinal emphysema (n=2). Five of the patients were operated urgently, five were operated within 24 hours, three were followed conservatively and lesions in two patients were repaired in a delayed fashion. Bronchoplastic procedures were applied commonly (62%). We had no mortality. Lesions of the two patients were recognized lately and one of them was operated one month, the other was operated three months later by bronchoplastic techniques.

Eight (53%) of the patients in our series were under 17 years. Our tracheobronchial trauma incidence was 1.4% in 1100 (adult=902, pediatric=198) patients who had thoracic trauma at the same period. Incidence of tracheobronchial trauma for adults and for pediatric patients were 0.7% and 4 respectively. Particularly, the incidence in pediatric patients is higher than mentioned in the lit - erature and it is probably due to higher rates of traffic and labor accidents in our country.

These kind of injuries might be underdiagnosed at a ratio of 20% and most of these patients are admitted to hospital within 3 months. Repeated bronchoscopies should be performed in the suspected cases. Anatomic resections should avoided, in patients who do not have lethal vascular and paranchymal damage. Under these circumstances “delayed repair” should be the procedure of choice.