Korean J Crit Care Med.  2014 Nov;29(4):344-347. 10.4266/kjccm.2014.29.4.344.

Lobar Bronchial Rupture with Persistent Atelectasis after Blunt Trauma

• Kim JH
• Kim KW
• Cho CS
• Lee SI
• Kim JY
• Kim KT
• Choe WJ
• Park JS
• Kim JW

• KMID: 2227745
• DOI: http://doi.org/10.4266/kjccm.2014.29.4.344

Abstract

Rupture limited to the lobar bronchus from blunt trauma is especially rare, and the symptoms are light so diagnosis is difficult. In a patient who visited the hospital complaining of shortness of breath after falling down, atelectasis continued in the chest x-ray. Four days after visiting the hospital, a left upper lobar bronchial rupture was diagnosed through a bronchoscopy and 3 dimensional chest computerized tomography. When diagnosis is delayed in the case of a rupture limited to the lobar bronchus, bronchial obstruction can occur from the formation of granulation tissue, so regular monitoring is important. Therefore, when atelectasis continues after blunt trauma, it is important to differentially diagnose a lobar bronchial rupture through tests such as bronchoscopy.

Keyword

bronchoscopy; lung injury; pulmonary atelectasis

MeSH Terms

Bronchi
Bronchoscopy
Diagnosis
Dyspnea
Granulation Tissue
Humans
Lung Injury
Pulmonary Atelectasis*
Rupture*
Thorax

Figure

• 

  Fig. 1. Chest X-ray on admission shows consolidation of left upper and right low lobe.

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  Fig. 2. Chest X-ray on 4th hospital day shows persistent left upper lobe atelectasis.

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  Fig. 3. Bronchoscopy shows stenosis of the left upper bronchus orifice (black arrow).

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  Fig. 4. Chest 3D computed tomography with airway reconstruction shows obstruction of left upper bronchus (yellow arrow).

Reference

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