Research

Chest computed tomography with multiplanar reformatted images for diagnosing traumatic bronchial rupture: a case report

Morgan Le Guen¹ , Catherine Beigelman² , Belaid Bouhemad¹ , Yang Wenjïe² , Frederic Marmion¹ and Jean-Jacques Rouby¹

¹  Department of Anesthesiology and Critical Care Medicine, Surgical Intensive Care Unit Pierre Viars and the Trauma Center, La Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, University Pierre et Marie Curie Paris-6, France

²  Department of Radiology, Surgical Intensive Care Unit Pierre Viars and the Trauma Center, La Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, University Pierre et Marie Curie Paris-6, France

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Critical Care 2007, 11:R94doi:10.1186/cc6109

Published:	3 September 2007

Abstract

Introduction

Unnoticed bronchial injury during the early stage of resuscitation of multiple trauma is not rare and increases mortality and morbidity.

Methods

Three-dimensional reconstruction of the airways using a workstation connected to a multidetector chest computed tomography (CT) scanner may change the diagnostic strategy in patients with blunt chest trauma with clinical signs evocative of bronchial rupture.

Results

In this case report of a young motor biker, a complete disruption of the intermediary trunk was first misdiagnosed using standard chest helical CT and bronchoscopy. Postprocessing procedures including three-dimensional extraction of the tracheobronchial tree were determinants for establishing the diagnosis, and emergent surgical repair was successfully performed. Follow-up using CT with three-dimensional reconstructions evidenced a bronchial stenosis located at the site of the rupture.

Conclusion

The present study demonstrates the potential interest of performing three-dimensional reconstructions by extraction of the tracheal–bronchial tree in patients with severe blunt chest trauma suspected of bronchial rupture.