چكيده لاتين :
Tracheobronchial injuries are uncommon and their successful diagnosis and treatment often
requires high level of suspicious. Surgical repairs should be individualized for each type of injury. This
article reviews diagnosis and management of traumatic injuries to the trachea and major bronchi. From
March 26, 1991 to March 20, 2003, twenty-seven patients with major airway trauma were managed in
Nemazee hospital, Shiraz, Iran. Afterwards these patients were prospectively studied, for a period of 10
years. The mechanism of injury was blunt trauma in 13 patients, stab wound in 6, gunshot in 2 patients,
and iatrogenic in 6. Two patients had associated esophageal injury. Twenty-one patients were male and
6 were female. Eight patients had major bronchial injury, 13 had cervical tracheal injury and 6 had
mediastinal tracheal injury. Six patients had re-implantation of main bronchus (5 right and 1 left), and
two patients had repair of bronchus with concomitant bi-lobectomy in one of them. In cases of tracheal
injury, 12 patients had primary repair of trachea with distal tracheostomy in two. However, 7 patients
were managed conservatively with later sleeve resection of trachea and laryngotracheal anastomosis in
three patients. There was no morbidity but three patients died. Tracheobronchial injury is extremely
challenging due to its early threat to life. A high level of suspicious and the liberal use of bronchoscope
are critical in the diagnosis of tracheobronchial injuries. Avoidance of iatrogenic complications, primary
repair and liberal use of autogenous tissue for wrapping or buttressing increases successful rate.
