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Preserving lung after traumatic transection of left lower lobe bronchus from bullet injury
  1. Muhammad Shoaib Hanif1,
  2. AH Mishwani1,
  3. J Oparka2 and
  4. K Buchan2
  1. 1Department of Surgery, Combined Military Hospital, Peshawar, Pakistan
  2. 2Department of Cardiothoracic Surgery, Aberdeen Royal Infirmary, Aberdeen, UK
  1. Correspondence to Lt Col (Dr) Muhammad Shoaib Hanif, Department of Surgery, Combined Military Hospital, Peshawar 25000, Pakistan; muhammadshoaibhanif{at}hotmail.com

Abstract

A 22-year-old soldier was shot in the left chest by a bullet from close range. He was found to have a left haemothorax and remained shocked despite aggressive resuscitation. Due to difficult terrain and night time movement restrictions, there were limitations to the transfer of patient. So he was attended at a peripheral hospital. At emergency thoracotomy, three segmental arteries to left upper lobe were ligated and haemostasis was secured. The level of transection of left lower lobe bronchus was identified to be below the origin of the apical segmental bronchus. The lower lobe bronchus was successfully re-attached and followed up with a daily bronchoscopic clearance of distal airway. The patient made a full recovery. Anastomosis of left lower lobe bronchus after traumatic transection is a viable option for preserving an amputated lobe, in trauma settings, provided haemostatic control has been adequately achieved.

  • Trauma Management
  • Received November 1, 2013.
  • Revision received December 20, 2013.
  • Accepted January 17, 2014.

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  • Received November 1, 2013.
  • Revision received December 20, 2013.
  • Accepted January 17, 2014.
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