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<p>Severe chest trauma poses a&#xa0;major challenge in emergency medicine due to the many vital and highly sensitive organs whose physiological function can be critically impaired by the forces acting on them during trauma. Chest trauma is therefore the second most common cause of trauma-related death in Germany after traumatic brain injury. Tracheobronchial injuries are rare but particularly difficult to diagnose and manage in emergency medical care phase. Hemoptysis, dyspnea, and skin emphysema must already raise suspicion of such injuries in the prehospital setting. In in-hospital diagnostic imaging, pneumomediastinum and persistent pneumothorax despite correctly inserted chest drains are strong indications of such an injury. If clinically suspected, a&#xa0;bronchoscopy must be performed to confirm the diagnosis, as it has a&#xa0;higher sensitivity than computed tomography. The lesion must then be functionally excluded by adapted airway management (often by double-lumen tracheal intubation) or extracorporeal membrane oxygenation and is usually treated surgically. The possible prehospital management and interdisciplinary in-hospital care of a&#xa0;patient with tracheobronchial injury is presented and discussed here on the basis of a&#xa0;case study.</p>

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Schweres Thoraxtrauma mit Trachealruptur – ein Fallbericht

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年12月20日

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  • Jasper van Hoek,
  • Thanh-Long Nguyen,
  • Maris Bartkevics,
  • Eleonora Torchetti,
  • Wolf Hautz,
  • Jürgen Knapp

摘要

Severe chest trauma poses a major challenge in emergency medicine due to the many vital and highly sensitive organs whose physiological function can be critically impaired by the forces acting on them during trauma. Chest trauma is therefore the second most common cause of trauma-related death in Germany after traumatic brain injury. Tracheobronchial injuries are rare but particularly difficult to diagnose and manage in emergency medical care phase. Hemoptysis, dyspnea, and skin emphysema must already raise suspicion of such injuries in the prehospital setting. In in-hospital diagnostic imaging, pneumomediastinum and persistent pneumothorax despite correctly inserted chest drains are strong indications of such an injury. If clinically suspected, a bronchoscopy must be performed to confirm the diagnosis, as it has a higher sensitivity than computed tomography. The lesion must then be functionally excluded by adapted airway management (often by double-lumen tracheal intubation) or extracorporeal membrane oxygenation and is usually treated surgically. The possible prehospital management and interdisciplinary in-hospital care of a patient with tracheobronchial injury is presented and discussed here on the basis of a case study.