Delayed Tension Pneumothorax – Identification and Treatment in Traumatic Bronchial Injury: An Interesting Presentation
Published: September 1, 2017 | DOI: https://doi.org/10.7860/JCDR/2017/27859.10642
Amit Gupta, Amulya Rattan, Sunil Kumar, Vinita Rathi
1. Additional Professor, Department of General Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
2. 2nd Year MCh Resident, Trauma Centre, All India Institute of Medical Sciences, Delhi, India.
3. Director Professor, Department of General Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.
4. Professor, Department of Radiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.
Correspondence
Dr. Amit Gupta,
Additional Professor, Department of General Surgery, All India Institute of Medical Sciences,
Rishikesh-249203, Uttarakhand, India.
E-mail: dramit2411@yahoo.co.in
A 13-year-old girl, who did not receive any treatment for few hours following Road Traffic Injury (RTI), reported to the Casualty Department and found to have patent airway with clinically normal C spine, air-hunger (RR 42/minute), trachea deviated to left, distended neck veins and absent breath sounds on the right side. The chest X-ray she carried, done immediately after the injury, showed right sided tension pneumothorax. She was put on oxygen at 11 L/minute and an Intercostal chest tube drainage (ICD) was inserted on right side. Her oxygen saturation (40%) failed to improve. ICD bag showed continuous bubbling and air entry remained absent on the right side. An urgent right thoracotomy was done which revealed right main bronchus tear; the tear was repaired using interrupted Prolene® sutures. Patient recovered well and was discharged 10 days later in a stable condition.
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