2018 Volume 32 Issue 2 Pages 216-220
A 26-year-old man was transported to our hospital after being involved in a car accident. A chest roentgenogram after endotracheal intubation showed right tension pneumothorax. We immediately performed thoracic drainage; however, the right lung was still collapsed, with continuous and massive air-leakage. We urgently performed bronchoscopy and observed no abnormal findings in the trachea or primary bronchi. A suspicion of airway injury remained due to a large amount of air-leakage. Accordingly, we decided to perform an emergency operation. The middle-lobe bronchus had been completely transected at the root. Consequently, we could not avoid performing middle-lobe lobectomy. Tracheobronchial injuries have been reported to make up 1% of blunt thoracic traumas, and middle bronchial ruptures make up approximately 1% of them. In general, traumatic airway injuries are rare and occasionally difficult to diagnose early. Whenever a large amount of air-leakage is observed after tube drainage, we should take into consideration the possibility of tracheobronchial injuries and perform thoracotomy without delay.
