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[Tracheobronchial Injury].

Tracheobronchial injurie( TBI) is rare but potentially life threatening. Blunt trauma of the chest and post-intubation injury are the most common cause of TBI. Clinical findings of TBI are subcutaneous emphysema, pneumomediastinum, and pneumothorax. Chest computed tomography (CT) and bronchoscopy are important examination for TBI to evaluate of injured site and condition. Most traumatic or iatrogenic TBIs occurred within 2.5 cm of the carina and/or main bronchus. Early diagnosis and early treatment are important to improve the long-term results of TBI. In principle, blunt traumatic TBI excluded membranous minor laceration should be operated immediately, if possible. Surgical procedures are usually selected single closure or end to end anastomosis with or without débridement. Right thoracotomy is often suitable for repair of carina or main bronchus in closed trauma. Recently transcervical repair of iatrogenic distal membranous tracheal laceration is reported. Conservative treatment of iatrogenic TBI cause by single lumen tube may be a save option in patients with stable spontaneous breathing, no other injury( such as esophagus), and small to moderate rupture. Left main bronchial rupture caused by double lumen tube during right thoracic surgery is critical situation. Throughout the operation expert cooperation between surgeon and anesthetist is important.

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