Traumatic Lacerations of the Right Middle Lobar Bronchus-A Case Report

外傷導致的右中葉支氣管撕裂傷－病例報告

盧俊安(Chun-An Lu) ； 劉永恆(Yung-Heng Liu) ； 陳志弘(Chih-Hung Chen)

《胸腔醫學》 21卷1期 (2006/02) Pp. 70-74

https://doi.org/10.29806/TM.200602.0011

摘要

在胸部鈍挫傷中，氣管支氣管撕裂傷是罕見但是是非常嚴重的併發症。它大部分發生氣管隆凸和主支氣管的位置。發生在右中葉支氣管更是罕見。開刀修復是對於氣管支氣管撕裂傷的主要治療方法。
本篇報告提出一位20歲健康女性因為外傷導致右中葉支氣管撕裂傷的病例報告。她在車禍中受到胸部的直接鈍挫傷，臨床的表現主要以胸痛及呼吸窘迫為主。在胸部X光發現頸部及胸部的皮下氣腫、心包膜氣胸、肋骨骨折、左邊肺葉挫傷和右胸放置了一根胸管。在軟式的支氣管鏡的檢查下發現在右中葉支氣管的後壁分別各有一個2cm及1cm長的撕裂傷。尚於撕裂傷口不大及臨床症候並未持續惡化，她並未接受開刀的治療。在7天後的支氣管檢查發現這些撕裂傷已經癒合相當的良好，她並在隔天出院。

關鍵字

胸部鈍挫傷 ； 右中葉支氣管 ； 撕裂傷

並列摘要

Tracheobronchial injury is a rare, but serious complication of blunt thoracic trauma. The injury is always near the carina and the main bronchus, but is seldom in the right middle lobar bronchus. Surgical intervention of a deficiency is still the major treatment.
Herein, we described the case of a healthy 20-year-old woman with 2 traumatic lacerations of the right middle lobar bronchus (RMLB). She suffered blunt thoracic trauma in a traffic accident and clinically presented as chest pain and respiratory distress. The chest radiograph disclosed cervical and thoracic subcutaneous emphysema, pneumopericardium, rib fractures and left lung contusions and thoracic drainage in the right lung. The fiberoptic bronchoscopy found 2 longitudinal lacerations, 2cm and 1cm, respectively, on the posterior wall of the RMLB. The patient did not undergo surgical repair because the lesions were minor, and the clinical symptoms did not deteriorate. The lacerations healed well after 7 days of conservative treatment. She was discharged the next day.

並列關鍵字

blunt thoracic trauma ； right middle lobar bronchus ； laceration