Tracheobronchial Trauma

DEFINITION
Injury to the major airway passages, unusual and often catastrophic.

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EPIDEMIOLOGY
Unusual
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AETIOLOGY
Trauma.

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BIOLOGICAL BEHAVIOUR

Pathophysiology
Most injuries occur within 1 inch of the carina

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MANIFESTATIONS

Many die at the scene.
Haemoptysis
Subcutaneous emphysema.
Tension pneumothorax
Persistent air leak after chest tube insertion.


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INVESTIGATIONS

Bronchoscopy
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MANAGEMENT

Many die at scene
Those that don't often die at hospital from assiciated injuries
Opposite main stem bronchial intubation may be temporarily required for oxygenation.
- intubation may be difficult due to anatomic distortions from haematoma, injury.
Immediate surgical consultation and possibly operative intervention is indicated.
- some more stable pts, operative Rx may be delayed until acute inflammation/oedema has settled.

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REFERENCES