2002 Volume 16 Issue 1 Pages 85-89
The incidence of tracheobronchial disruption injury in cases of blunt chest trauma is low, but the associated mortality rate is high. However, accurate pathologic assessment using appropriate diagnostic imaging and early treatment may be useful in reducing the mortality rate in patients with this injury. We report here the case of the eighteen-year-old male of a motorcycle accident patient for whom chest roentgenogram on admission aided the diagnosis of injury of the right main bronchus (Japanese Association for the Surgery of Trauma in Japan, Tracheobronchial Injury Classification Ib) Tracheobronchial stripe, emphysema shadows around the trachea and the right main bronchus, the continuous diaphragm sign, and right Naclerio's V-sign were observed on the chest roentgenography, suggesting mediastinal emphysema. In addition, the shadow of the right main bronchus near the azygos vein was blurred, and a shadow indicative of hematoma was observed around the lateral azygos vein. Based on these two findings in particular we made a diagnosis of disruption injury of the right main bronchus. The injured site was closed by direct suture repair and postoperatively the patient's condition is good.
