Verletzungen des Tracheobronchialbaums

 

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Zusammenfassung

Verletzungen des Tracheobronchialbaums sind seltene, aber meist lebensbedrohliche Ereignisse, deren adäquates Management eine hohe thoraxchirurgische Expertise erfordert. Die Genese der Verletzung – iatrogen oder traumatisch – gibt erste wichtige Hinweise auf das Verletzungsmuster. Die Bronchoskopie ist die zentrale Diagnostik zur Abschätzung des Ausmaßes der Verletzung. Typische iatrogene Verletzungen der Tracheahinterwand werden je nach Schweregrad konservativ oder operativ behandelt. Im Gegensatz dazu erfordern traumatische stumpfe oder penetrierende Verletzungen des Tracheobronchialbaums regelhaft das chirurgische Vorgehen, welches typischerweise eine technisch anspruchsvolle Rekonstruktion des Atemwegs beinhaltet.

Abstract

Tracheobronchial injuries are rare events but often life-threatening. A great expertise in the field of thoracic surgery is necessary to manage these events. The aetiology of the injury – traumatic or iatrogenic – allows immediate considerations about the pattern of damage. The flexible or rigid bronchoscopy is the central diagnostic procedure to classify the injury. Whereas iatrogenic tracheal lacerations can be treated by conservative or operative means depending on severity, traumatic injuries of the tracheo-bronchial system need technically challenging operative reconstructions in almost every case.

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