• Journal of Chest Surgery
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• v.24 no.5
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• pp.480-484
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• 1991

Traumatic rupture of the main bronchus is comparatively very rare. With the advent of widespread mechanization and high-speed era, the incidence of traumatic rupture of the tracheobronchial tree has been increased considerably. Rupture of the bronchus is an unusual result of nonpenetrating trauma to the chest. Early recognition of bronchial rupture and emergency thoracotomy and management is essential for reducing of morbidity, mortality and late complications. We experienced 3 cases of bronchial rupture caused by nonpenetrating chest trauma with or without rib fracture. Patients were suffered from dyspnea and chest pain. After closed thoracostomy, corrective surgery was performed. Postoperative courses were uneventful and discharged without any complication.

• Journal of Chest Surgery
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• v.28 no.5
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• pp.513-517
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• 1995

The injuries to the bronchi have been reported with increasing frequencies. The most common cause of such injuries is compression or crushing chest trauma. Early diagnosis and emergent repair should be done for the good prognosis. We report 3 cases who had bronchial injuries after traffic accident. Our operative procedures were a primary bronchial repair for 17 months old boy, a pneumonectomy for delayed recognition and a bronchoplasty procedure 63 days after trauma. All these bronchial ruptures were successfully treated and discharged.

• Tuberculosis and Respiratory Diseases
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• v.41 no.5
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• pp.574-578
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• 1994

The incidence of traumatic rupture of the tracheobronchial tree has been increased considerably with advent of widespread mechanization and high speed era. Rupture of the bronchus is an unusual result of nonpenetrating trauma to chest. Early diagnosis and primary repair not only restore normal lung function but also avoid difficulties and complications associated with delayed diagnosis and repair. These complications are pneumonia, atelectasis and lung abscess secondary to the bronchial obtruction. We experienced a case of partial rupture on left main bronchus caused by nonpenetrating blunt chest trauma with rib fractures 1 year ago. He was suffered from progressively developing dyspnea on exercise and treated as bronchial asthma at other hospital. Bronchoscopic finding was the narrowed lumen of left main bronchus at 1cm from carina by web-like membrane. We confirmed by bronchogram and repaired by end to end anastomosis, which is rare delayed finding in bronchial rupture without pulmonary complications. We report a case of nonpenetrating traumatic bronchial rupture, manifested by bronchial web in bronchoscopy.

• Journal of Chest Surgery
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• v.25 no.10
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• pp.1121-1124
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• 1992

Rupture of a bronchus is an unusual result of blunt trauma to the chest. We experienced a case of bronchial rupture caused by blunt chest trauma without external wound or rib fracture. This case was a 13 years old male who was elementary school student. He was compressed on anterior chest by basket ball goal post being failed down on the afternoon of admission day. After this accident, he was suffered from progressive dyspnea and chest pain. The bronchial rupture was confirmed by bronchogram, The operation was performed through standard posterolateral thoracotomy incision along the 5th rib course. The right upper lobe bronchus and intermediate bronchus was completely transected. The right upper lobectomy was done. The ruptured intermediate bronchus was connected direct simply. Post-operative course was uneventful. Thus we report this case of traumatic bronchial rupture with review of literature.

• Journal of Chest Surgery
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• v.31 no.10
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• pp.1014-1016
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• 1998

Rupture of the bronchus following endotracheal intubation with a double-lumen tube is extremely rare in all complications of endotracheal intubation. We experienced a case of left main bronchial rupture following endotracheal intubation. This 58-year old female patient was diagnosed of well-differentiated adenocarcinoma of right lower lobe, stage IIB, preoperatively. She was intubated with Robertshaw double-lumen tube(35 Fr.) for Rt. lower lobectomy. Intraoperatively, Lt. main bronchial rupture was suspected because of pneumomediastinum and ventilation insufficiency and immediately repaired with monofilament absorbable sutures(PDS) through left thoracotomy. Postoperative course was uneventful.

• Journal of Chest Surgery
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• v.29 no.3
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• pp.355-359
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• 1996

Rupture of the main bronchus due to blunt chest trauma is very rare, especially In childhood although the incidence is increasing. Early diagnosis and primary repair not. only restore normal lung function but also avoid the difficulties and complications associated with delayed diagnosis and repair. We experienced 2 cases of right main bronchial rupture caused by traffic accidents. Patients suffered from progressively developing dyspnea and subcutaneous emphysema on the neck, anteriorchest,andanteriorabdominalwall. Emergency operations were performed through right posterolateral thoracotomy incision at the 4th intercostal space. Intraoperatively, the right main bronchus completely transsected and separated. Corrective bronchoplasty was performed with end-to-end anastomosis using interrupted suture with 3-0 Vicryle and the suture line was reinforced with azygos vein and parietal pleural flap. Postoperative courses were uneventful and patients discharged without any specific pro lems.

• Journal of Chest Surgery
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• v.9 no.1
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• pp.38-40
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• 1976

Rupture of a bronchus is an unusual result of nonpenetrating trauma to the chest. This case was a 19 year old male who was a worker in the mine. The patient had sustained a compression chest injury without external wound or rib fracture. At five days after trauma, he was suffered from dyspnea and the symptom was progressively increased. Two weeks after the chest trauma, a diagnosis of left main bronchial obstruction due to traumatic bronchial rupture was made by means of bronchoscopy and bronchography. He was operated upon. The left lung was completely atelectatic and the left main bronchus was found to be transected at the level of 3cm from carina. End-to-end anastomosis of the bronchus was performed and the left lung was aerated very well. postoperative course was uneventful.

• Journal of Chest Surgery
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• v.21 no.3
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• pp.547-552
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• 1988

Rupture of the main bronchus followed by blunt chest trauma is comparatively very rare. Early recognition of bronchial rupture and emergency thoracostomy and management is essential for reducing of morbidity and mortality and late complications. This case was 11 years old female who was a primary school student. The patient was sustained a crushing injury to her right hemithorax by traffic accident and had been taken emergency closed thoracostomy at her second intercostal space, midclavicular line at emergency room. In the course of the next 2 hours, the girl`s condition remained critical with tension pneumothorax and abnormal arterial blood gas analysis. Induction of anesthesia started 3 hours after the accident. During the general anesthesia, cardiac arrest was occurred and cardiac resuscitation was performed. Right upper lobectomy and end-to-end anastomosis of ruptured right main bronchus was performed. Postoperative course was satisfactory.

• Journal of Chest Surgery
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• v.44 no.4
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• pp.314-317
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• 2011

A bronchial artery aneurysm (BAA) is uncommon and usually associated with chronic inflammatory lung disease or a systemic vascular condition, which is rarely the etiology of mediastinal hemorrhage. A middle-aged person presented with spontaneous hemothorax and hemomediastinum. A diagnostic evaluation identified a bronchial artery aneurysm as the source. To prevent further rupture, we performed a bronchial artery embolization. In the absence of trauma or other causes for hemothorax and mediastinal hemorrhage, the possibility of a BAA should be considered. A bronchial artery aneurysm can be managed by interventional techniques as well as surgery.

• Journal of Chest Surgery
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• v.22 no.3
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• pp.416-424
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• 1989

We have performed eight, single transplantations of right lung in dogs from September, 1988 to March 1989 at the Thoracic & Cardiovascular Surgical department, Yonsei University, College of Medicine, Seoul, Korea. We wrapped bronchial anastomosis site with great omentum and used cyclosporin in preoperative and postoperative periods in seven cases except one. The one without wrapping the bronchial anastomotic site with omentum and using cyclosporin died due to bronchial anastomotic site rupture in postoperative fourth day. If there is no reason to choose one side over the other, we would generally choose to do left-sided transplant as this is technically somewhat easier because of the long length of recipient bronchus and the ease of clamping the left atrium proximal to the pulmonary veins. The right atrium limits the amount of left atrium that can have incorporated into the clamp proximal to the pulmonary veins on the right side. But we had chosen to do right-sided transplant of lung because we must take variable technical experiences on right sided lung transplant in dogs. We have to anastomose one of pulmonary vein and left atrial wall on right-sided transplant easily only with double ligation of one pulmonary vein because right atrium limited the clamp of left atrium proximal to pulmonary veins with decreased venous return and cardiac output in some dogs. All seven dogs with right-sided lung transplant had survived more than one day with good condition except one. The one dog have to be sacrificed to evaluate the difference between the gas analysis in pulmonary venous and arterial blood in post-operative eight hours. We found hemorrhagic pulmonary edematous changes of contralateral left lung in this dog. And also all dogs have to be sacrificed for the evaluation of surgical problems, anytime in post-operative periods without any cardiopulmonary resuscitative efforts when the general condition would be worse progressively. We found no any surgical technical errors in seven dogs except one with thrombi in suture site of left atrium. There were hemorrhagic pulmonary edematous changes of transplanted right lung in one, of contralateral left lung in one, of contralateral left lung with double ligation of its pulmonary artery in one, thrombi around left atrial sutures sites in one, multiple air leakage in one bronchial rupture in one due to rejection or infection. There were accidental extubation and delayed intubation in one and unknown cause of death in one.