Emergency Venovenous Extracorporeal Membrane Oxygenation-Supported Repair of Complex Right Main Bronchus and Pulmonary Artery Rupture.

Traumatic rupture of the right main bronchus with pulmonary artery injury is exceptionally rare and often fatal when pneumonectomy is required. An 18-year-old man presented with bronchial transection and pulmonary artery rupture after chest trauma. Venovenous extracorporeal membrane oxygenation enabled oxygenation during controlled thoracotomy. A parenchyma-sparing strategy was adopted: right upper lobectomy, pulmonary artery repair, and end-to-end bronchial anastomosis, avoiding pneumonectomy. Secondary bronchial dehiscence with bronchovascular fistula was successfully managed by omental flap repair. This case demonstrates that early recognition, extracorporeal membrane oxygenation support, and lung-preserving reconstruction are key to survival in catastrophic bronchovascular trauma.