An audit of tracheobronchial tree injuries at Inkosi Albert Luthuli Central Hospital, Durban, KwaZulu-Natal

Abstract

Background: Tracheobronchial tree injuries (TBTI) represent a type of trauma that is rare among all trauma patients, with a paucity of literature available in Africa. These may result from blunt or penetrating trauma to the neck and thorax (chest). The purpose of this study was to document the spectrum of injury and the experience with surgical and nonsurgical management and outcome of TBTI in the KwaZulu-Natal setting.

Methods: This was a single-centre retrospective analysis of all patients with TBTI referred to Inkosi Albert Luthuli Central Hospital (IALCH) over 21 years. Data collection extended from 1 January 2003 to 31 December 2023.

Results: Penetrating trauma was the most common cause of injury, with a total of 32 patients (86%), while blunt injuries were seen in five patients (14%). Anatomically, there were 20 cervical tracheal injuries, eight thoracic tracheal injuries, six bronchial injuries and three multiple site injuries. A total of 27 (73%) patients underwent surgery, while 10 (27%) patients were managed conservatively. Overall mortality was seen in four patients and one patient survived with long-term disease sequelae. The overall median duration hospital stay was 6 days (IQR 4–10).

Conclusion: TBTI remains a rare injury. Sepsis was one of the main causes of death in both surgical and conservative management. Conservative management in selected cases is just as effective as definitive surgical management. Overall, there was good outcome with TBTI in this centre.