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Aortic Rupture and Concomitant Transection of the Left Bronchus After Blunt Chest Trauma*

Miralem Pasic, MD, PhD; Ralf Ewert, MD; Marcus Engel, MD; Norbert Franz; Peter Bergs, MD; Hermann Kuppe, MD, PhD; Roland Hetzer, MD, PhD
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*From the Deutsches Herzzentrum Berlin, Berlin, Germany. Manuscript received June 9, 1999; revision accepted October 10, 1999.

Correspondence to: Miralem Pasic, MD, PhD, Deutsches Herzzentrum Berlin, Klinik für Herz-, Thorax- and Gefässchirurgie, Augustenburger Platz 1, D-13353 Berlin, Germany; e-mail: pasic@dhzb.de



Chest. 2000;117(5):1508-1510. doi:10.1378/chest.117.5.1508
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We report a patient with traumatic aortic rupture and preoperatively unrecognized complete disruption of the bronchus for the left lower lobe. Preoperative state was complicated by inadequate oxygenation due to total atelectasis of the unventilated collapsed left lower lobe with consequent significant shunting of the unoxygenated blood. The patient had no massive pneumothorax because the intact peribronchial tissue and pleura covered the injured place, preventing important air leakage. The suspicion of possible concomitant tracheobronchial injury and early diagnostic bronchoscopy are important in patients with aortic rupture after blunt chest trauma.

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