One hundred sixty-seven cases of bronchial rupture have been reported, showing a 10-fold increase in incidence in the past 10 years. The injury has 2 phases: rupture of the bronchus itself, followed by the development of a stricture at the site of rupture. Early diagnosis and repair are mandatory to prevent stricture and loss of lung function. The presence or absence of pneumothorax, hemoptysis, or emphysema is of little value in early diagnosis. Rib fractures are always associated with bronchial rupture in patients over age 30 but are frequently not seen in patients under age 30. Ninety-one per cent of the patients with bronchial rupture and broken ribs had one or all of the first 3 ribs broken, and 86% of all bronchial ruptures involved the main bronchi.
Burke JF. Early Diagnosis of Traumatic Rupture of the Bronchus. JAMA. 1962;181(8):682–686. doi:10.1001/jama.1962.03050340020005
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