Bronchial Rupture: Emphasis on Radiological Presentations

支氣管破裂症為罕見之外傷，常併發於胸部鈍傷，其在臨床表現上嚴重度不一。事實上，延誤診斷則常危及生命。本研究中，我們將報告本院四例支氣管破裂症。在放射學上，他們常呈現氣胸/血胸，氣縱膈及深頸部氣腫；至於以前大家強調的標準表徵「墜落肺」則只出現於一個病例而已，其出現率甚低，以致於我們百分之五十的病人最初無法正確診斷。總而言之，於此類病患最重要的是在插胸管後，若發現氣胸仍持續存在時必須考慮此症。

關鍵字

胸部外傷；支氣管破裂症；墜落肺症；氣胸

並列摘要

Bronchial rupture is a rare injury associated with blunt chest trauma. Clinical severity varies from mild to disastrous. It is frequently life-threatening, particularly when the diagnosis is delayed. In this study, we report our experience regarding 4 patients with this kind of injury. Roentgenographic presentations included pneumothorax /hemothorax, pneumomediastinum, and deep cervical emphysema. Only one patient, however, demonstrated the classic radiologic sign of ‘a fallen lung’ on an erect chest x-ray. The diagnosis was overlooked during the initial phase of management in half of our patients. While the fallen lung sign is diagnostic of bronchial disruption, it has a low sensitivity for identifying bronchial injury. The most important clue for this diagnosis is a persistent pneumothorax following adequate tube drainage.

並列關鍵字

chest trauma ； bronchial rupture ； a fallen lung ； pneumothorax

國際替代計量

Bronchial Rupture: Emphasis on Radiological Presentations

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