Abstract
Among blunt chest injuries, traumatic bronchial rupture is very rare. It often occurs without fracture of the ribs and making the early diagnosis of this disease is not always easy in children.
A 4-year-old girl was injured her chest by a fall accident. A chest radiograph showed a right pneumothorax and contusion with no rib fractures. Emergency bronchoscopy showed no abnormality in the trachea and main bronchus. Three weeks later bronchoscopy demonstrated that the right upper bronchial orifice was completely occluded with granuloma tissue. The patient was diagnosed as bronchial rupture. A conservative therapy was selected for her growth and no other significant complications. The clinical course is being followed up by chest radiography.
In Japan, prior to our report, only one case presenting the rupture at the upper bronchus has been reported. even a child case needs emergency operation, if a large quantity of air leak or bleeding from thoracic drainage is observed, drainage fails to expand the lung, or an advancing percutaneous mediastinal emphysema is noted. However, conservative treatment should give satisfactory outcome for child case in which the bronchial injury is located below the lobar bronchi and no complication such as pneumonia due to pneumothorax is associated by.
