Post-Traumatic Left Main Bronchus Stenosis: Case Report

創傷後左主支氣管狹窄－病例報告

張凱惟(Kai-Wei Chang) ； 顏亦廷(Yi-Ting Yen) ； 曾堯麟(Yau-Lin Tseng) ； 賴吾為(Wu-Wei Lai)

《胸腔醫學》 30卷4期 (2015/08) Pp. 239-246

摘要

胸部鈍傷後引起的氣管支氣管損傷是一種罕見但潛在的致命傷害。診斷和治療時常被延遲，而導致在受傷後幾個月或甚至幾年後才進行修復手術。我們描述一個創傷後左主支氣管狹窄的病例。然而在確定診斷之前，患者因左肺整片變白而接受胸管置入術，進而導致脾臟穿刺傷。藉此再次強調「安全三角區域」和超音波導引在胸腔引流中的重要性。而此病人在創傷晚期以支氣管狹窄呈現，則成功地藉由左主支氣管袖狀切除及重建來處理。

關鍵字

氣管支氣管損傷 ； 胸管置入術 ； 脾臟穿刺傷

並列摘要

Tracheobronchial injury following blunt chest trauma is a rare but potentially lethal injury. Often the diagnosis and treatment are delayed, resulting in attempted surgical repair months or even years after the injury. We described the case of a patient with post-traumatic left main bronchus stenosis. Before the diagnosis, the patient, with left lung white-out, was subjected to a tube thoracostomy, resulting in splenic penetration. Thus, the importance of a ＂safe triangle＂ and ultrasound guidance are emphasized for chest drainage. The late injury presenting as a stenosis was successfully managed by sleeve resection and reconstruction of the left main bronchus.

並列關鍵字

tracheobronchial injury ； tube thoracostomy ； splenic penetration