1/12. Left upper lobe bronchus reimplantation for nonpenetrating thoracic trauma.Trauma to the tracheobronchial tree has been diagnosed and treated with increasing frequency over the last several decades. However, most reports have dealt with management of injuries to the trachea and main stem bronchi, as approximately 80% of blunt tracheobronchial injuries occur within this area. With few exceptions, injury to the lobar bronchi has resulted in thoracotomy and lobectomy. We describe a patient with an injury to the left upper lobe bronchus who presented with delayed obstruction of the airway by fibrogranulation tissue. A successful segmental resection of the bronchial occlusion with reimplantation was performed, thereby preserving the patient's otherwise normal left upper lobe. This case demonstrates that resection and reimplantation of an injured lobar bronchus are feasible, even in a delayed setting.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
2/12. Fatal air embolism during thoracotomy for gunshot injury to the lung. Report of a case.Fatal coronary air embolism occurred during thoracotomy in a patient with a gunshot wound involving the hilum of the right lung. embolism was observed during a second period of failure of heart action. Evidently, air entered the pulmonary veins from the bronchus, which was receiving positive-pressure ventilation. The literature contains reports of only 3 similar cases, but we suspect that air embolism may be responsible for death and morbidity in additional cases in which accidental or iatrogenic lung trauma has produced a pathway between the bronchial tree and the pulmonary veins.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
3/12. Bizarre impalement fatalities--where is the implement?Two fatalities due to unusual impalement injuries are reported. (1) A large branch broken off during a storm had entered a passing car and perforated the chest of the driver and the back of the seat. The chest organs were grossly lacerated. The car was subsequently stopped by another tree and this second impact removed the wood from the body. (2) A man suffered anorectal impalement by the leg of a stool turned upside down. He had introduced one stool leg into his anus for sexual stimulation and fell onto it. This resulted in a wound channel 36 cm long including perforation of the rectum, urinary bladder, mesentery, transverse mesocolon and liver. Before autopsy, the mode of death was unclear because the man had removed the stool leg himself, his wife had hidden the stool from the scene, and there were no relevant external injuries. In both cases, a reliable reconstruction required investigation of the scene and consideration of extremely unlikely circumstances or of bizarre human activities.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
4/12. Anaesthetic management of tracheobronchial rupture following blunt chest trauma.Injuries to the tracheobronchial tree are a well-recognized sequel of massive blunt trauma to the chest, and although unusual, are life threatening. We report a 16-year-old-boy who developed complete disruption of both bronchi after a motor vehicle accident. After induction of general anaesthesia and oral intubation, ventilation could not be maintained, and oxygenation worsened abruptly with peripheral oxygen saturation values less than 60%. Jet ventilation through two intrabronchial catheters, inserted via emergency thoracotomy, raised the saturation from 60% to 100%, and surgery thereafter was straightforward. The anaesthetic management of tracheobronchial repair is discussed.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
5/12. azygos vein laceration following a vertical deceleration injury.A 41-year-old man presented with respiratory distress and hypotension after a 30-foot fall from a tree. Despite fluid resuscitation, the patient expired in the operating room. autopsy revealed an azygos vein laceration at the junction of the superior vena cava as the cause of death. azygos vein and superior vena caval lacerations are rare following blunt chest trauma, including vertical deceleration injury. Early suspicion of vascular injuries with aggressive fluid resuscitation and surgical intervention remain the only hope for survival from this highly lethal injury.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
6/12. Successful surgical treatment of a combined abdominal and thoracic impalement injury.accidents do occur during the performance of different domestic chores in the garden. The resulting injuries can lead to serious morbidity and, in some cases, they can be fatal. We present a case of trauma, in a 69-year old man, caused by a fall from a tree on a vertical metal rod in his garden. The rod entered the abdominolumbal region on the right side making an exit above the left clavicle. On arrival, he was in a stable circulatory condition. A chest X-ray (Fig. ), thoracic and abdominal sonography followed by chest and abdominal CT scan (Figs. - , ) were performed and they showed no severe injury of the heart, lung, bronchi, liver and right kidney. He underwent an emergent surgical intervention by a team of cardiothoracic, vascular and abdominal surgeons. Longitudinal sternotomy and laparotomy allowed us to remove the metal rod carefully with no severe signs of injuries of abdominal and thoracic organs. There were no surgical postoperative complications.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
7/12. aneurysm of the left anterior descending coronary artery after chest trauma.A 28-year old man developed transmural anterior wall myocardial infarction after a car accident despite the absence of external signs of chest trauma. coronary angiography one month after the accident demonstrated an aneurysm of the left anterior descending artery. Angiography five and eleven months afterwards showed almost total regression of the aneurysm. The man remained asymptomatic with no signs of residual ischaemia one year after the accident. Blunt trauma to the chest is a well-known cause of cardiac damage including myocardial contusion, rupture of the ventricular wall, septum, papillary muscles or chordae tendineae. Myocardial infarction secondary to distinct injury to a coronary artery has only seldom been described. Visualization of a localized lesion in a coronary artery of an otherwise non-atherosclerotic coronary tree supports the traumatic origin of a myocardial infarction.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
8/12. Blunt traumatic rupture of the thoracic oesophagus.A man with a crush injury of his upper abdomen developed bilateral pulmonary empyema after repair of tears of the oesophagus and liver. Attempts to withdraw chest drains led to recurrent septicaemia, treated by reinsertion of the drains plus administration of antibiotics. The communication of the empyema space with both the bronchial tree and the oesophagus was managed successfully with intermittent positive pressure ventilation and with a double lumen endobronchial tube isolating the right lung for 10 days. Traumatic rupture of the thoracic oesophagus carries a high mortality and prompt repair is vital.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
9/12. pneumoperitoneum resulting from tracheal rupture following blunt chest trauma.pneumoperitoneum usually implies perforation of the gastrointestinal tract, although the tracheobronchial tree has been recognized as a source for free intraperitoneal air. We report a case of pneumoperitoneum resulting from tracheobronchial rupture following blunt chest trauma, which was successfully treated by surgical repair.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
10/12. Blunt chest trauma with tracheobronchial rupture.The unusual complex of physiological problems associated with rupture of the tracheobronchial tree complicating blunt chest trauma is discussed. The mechanics of injury leading to rupture are abrupt compression of the chest with consequent fixation of the cervical trachea where it enters the mediastinum, separation of the lungs, and fracture of the bronchus over the vertebral bodies. Treatment by aspiration thoracentesis, tracheotomy, and thoracotomy with primary repair as well as expectant therapy are discussed. Two cases, one treated expectantly and one treated by thoracotomy, both with complete recovery, are presented.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
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