Tracheobronchial lesions after closed thoracic injuries

: We report the clinical picture and the outcome after medical and surgical treatment of eleven patients who had a traumatic rupture of the tracheobronchial tree between 1971 and 1990. The lesions occurred after a blunt chest trauma. All patients but one had evidence of extrapulmonary air leak on admission; one patient complained of hemoptysis. Seven patients underwent a fibroscopy on admission, which confirmed the rupture. One of them was operated immediately for tracheal rupture; four presented a small lesion which was medically treated; two were operated later on for secondary stenosis. Four patients didn't undergo a fibroscopy at first examination, one of them being asymptomatic. All four were operated secondarily. Of the six patients operated for secondary stenosis, three were operated within one month after the accident. This reflects the importance of other priorities at the initial stage. Of the three patients operated later on two didn't have a fibroscopy and it is impossible to assess the importance of the primary lesion. For the last patient operation was delayed because of the peripheral location of the lesion. The long term evolution was satisfactory in all cases.