September 1960

Closed Intrathoracic Ruptures of the Trachea and Bronchi

Author Affiliations

Houston, Texas
From the Surgical Service of St. Luke's Episcopal Hospital and the University of Texas Postgraduate School of Medicine.

Arch Surg. 1960;81(3):473-478. doi:10.1001/archsurg.1960.01300030133017

A powerful compressive blow to the chest may produce a tracheobronchial rupture without damage to the chest wall. In a review of the literature through January, 1959, reports of 90 such injuries were found. The theory which seems to account most satisfactorily for the rupture was suggested by Schönberg,10 i.e., high intraluminal pressure. As a result of a crushing force in the presence of a closed glottis, intrabronchial pressure greatly exceeds intrathoracic pressure and produces an explosive action which tears the trachea or a bronchus, or both. In approximately one-half the reported cases the victims were thrown violently under the wheel of a vehicle or were struck by one; one-third were crushed in an automobile collision, and the remainder were hurt in a fall or crushed beneath or between heavy objects.

Although the setting for tracheobronchial rupture is a common occurrence, the lesion is rare. Of 216 consecutive patients

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