[Iatrogenic Injury of the Bronchus Suspiciously Caused by Sengstaken-Blakemore Tube into the Airway].

BACKGROUND

Tracheobronchial injury is often operated urgently because of the risk of high mortality. However, small injuries can recover by conservative management.

CASE: A 65-year-old man was treated for esophageal varix with transcatheter arterial embolization therapy. He vomited blood and endoscopic sclerotherapy was performed because a Sengstaken-Blake-more tube could not be inserted. Thereafter, computed tomography( CT) detected mediastinal emphysema and an injury to his left main bronchus. The patient consulted our department and bronchoscopy detected a laceration of the left main bronchus. Conservative management was chosen because the laceration was limited to the membranous portion, with the improvement of inflammatory reaction. Several weeks later, CT and bronchoscopy confirmed recovery from the injury of the left main bronchus without stricture.

CONCLUSION

An operation is indicated for many tracheobronchial injuries. However, some injuries can recover with conservative management. It is important that indication for surgery should be considered based on bronchoscopic findings and the progress of inflammatory reaction.