Delayed repair of posttraumatic bronchial transection

Tracheobronchial injuries (TBI) are uncommon but potentially fatal injuries that can occur following blunt trauma to the thoracic region. Occasionally the diagnosis is not made at initial presentation, and patients present late with various sequelae. A 3 year old boy sustained blunt thoracic injury and developed respiratory distress, pneumothorax, and subcutaneous emphysema, which were managed conservatively with intercostal tube. Bronchoscopy performed to assess the cause of persistent collapse of the right lung and continued respiratory distress showed complete block of right main bronchus one cm away from the carina. Thoracotomy was performed and the transected ends of the bronchus were anastomosed. Postoperatively the right lung expanded with relief in respiratory distress. This report highlights the success of delayed repair of TBIs as an alternative to pneumonectomy.