Surgical treatment of delayed partial bronchial rupture under venovenous extracorporeal membrane oxygenation support: a case report.

Abstract

Background: Chest trauma may precipitate a spectrum of injuries, among which tracheal laceration represents an uncommon but critical sequela. The occurrence of tracheal laceration could significantly impair respiratory and cardiovascular homeostasis, thereby posing a life-threatening risk to the patient. Expeditious surgical intervention is paramount for therapeutic management, and in certain instances, the administration of venovenous extracorporeal membrane oxygenation (VV ECMO) may be necessitated to support the patient's respiratory function.

Case presentation: This case report discusses the surgical management of a delayed partial bronchial rupture following thoracic trauma, supported by VV ECMO. The patient, who sustained multiple rib fractures, hemopneumothorax, and scapular fractures due to a motor vehicle accident, developed progressive dyspnea one month post-trauma. Imaging revealed right lung atelectasis and pleural effusion, necessitating emergency surgery. VV ECMO was used to stabilize oxygenation, allowing for successful right main bronchus resection and anastomosis. Intraoperative bronchoscopy played a crucial role in identifying the rupture site and ensuring effective anastomosis. The patient recovered well, with no significant complications at follow-up.

Conclusions: This case highlights the importance of timely surgical intervention in bronchial rupture, the utility of VV ECMO for respiratory support, and the role of bronchoscopy in managing airway injuries. It underscores that delayed bronchial rupture, though rare, requires prompt recognition and treatment to prevent life-threatening complications.