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Imagen Clínica
Laceración traqueobronquial tras traumatismo torácico cerrado
Tracheobronchial Laceration After Blunt Chest Trauma
Diana Veiga Canuto
Corresponding author
dianaveigac@gmail.com

Autor para correspondencia.
, Joan Carreres Polo
Servicio de Radiología, Área Clínica de Imagen Médica, Hospital Universitari i Politècnic La Fe, Valencia, España
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Var&#243;n de 50 a&#241;os politraumatizado&#46; En la TC tor&#225;cica con contraste intravenoso se identific&#243; una laceraci&#243;n del bronquio intermediario &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">La laceraci&#243;n traqueobronquial es infrecuente en la pr&#225;ctica cl&#237;nica &#40;0&#44;2-8&#37; de traumatismos tor&#225;cicos cerrados&#41; porque el 81&#37; de los pacientes fallecen en el acto por otras causas<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1&#44;2</span></a>&#46; Com&#250;nmente su diagn&#243;stico es tard&#237;o al enmascararse por otras lesiones traum&#225;ticas&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Las roturas bronquiales son t&#237;picamente paralelas a los anillos cartilaginosos&#44; a menos de 2&#44;5<span class="elsevierStyleHsp" style=""></span>cm del &#225;ngulo carinal&#44; y muestran ligero predominio en el lado derecho<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1&#44;2</span></a>&#46; Por imagen pueden visualizarse signos indirectos como el neumomediastino y el enfisema cervicotor&#225;cico&#46; Si la lesi&#243;n alcanza el espacio pleural se produce neumot&#243;rax persistente&#44; refractario a la colocaci&#243;n de tubo de drenaje&#46; La TC tiene un papel fundamental&#44; permite identificar directamente la discontinuidad de la v&#237;a a&#233;rea&#44; la angulaci&#243;n&#44; el defecto o la amputaci&#243;n bronquial&#46; Si la lesi&#243;n es completa&#44; el pulm&#243;n puede colapsarse y alejarse del hilio hacia partes declives&#44; denomin&#225;ndose el &#171;signo del pulm&#243;n ca&#237;do&#187;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Las im&#225;genes de TC con reconstrucciones multiplanares de m&#237;nima intensidad son &#250;tiles en caso de sospecha de lesi&#243;n traqueobronquial&#46; La broncoscopia permite confirmar el diagn&#243;stico y evaluar su extensi&#243;n&#46; Debe realizarse cirug&#237;a precoz para intentar la reparaci&#243;n primaria<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1&#44;2</span></a>&#46;</p></span>"
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          "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">TC de t&#243;rax con contraste intravenoso&#58; A&#41; Plano axial&#44; ventana de pulm&#243;n&#46; Signo del pulm&#243;n ca&#237;do &#40;flecha blanca discontinua&#41; por colapso y desplazamiento del hilio pulmonar hacia partes declives&#46; Se observa tambi&#233;n neumot&#243;rax derecho a tensi&#243;n &#40;asterisco blanco&#41; que condiciona desplazamiento mediast&#237;nico contralateral y neumopericardio &#40;flecha negra discontinua&#41;&#46; B&#41; Reconstrucci&#243;n coronal&#44; ventana de pulm&#243;n&#46; Neumomediastino con aire rodeando los bronquios y los vasos pulmonares de disposici&#243;n paralela a los mismos en el hilio pulmonar &#40;cabeza de flecha negra&#41;&#46; C&#41; Reconstrucci&#243;n multiplanar con proyecci&#243;n de m&#237;nima intensidad &#40;MiniP&#41;&#44; plano coronal&#44; ventana de pulm&#243;n donde se identifica enfisema subcut&#225;neo &#40;flecha negra continua&#41; y discontinuidad de la v&#237;a a&#233;rea &#40;flecha blanca&#41;&#46; D&#41; Reconstrucci&#243;n volum&#233;trica 3D&#44; proyecci&#243;n anteroposterior con supresi&#243;n de pulm&#243;n derecho&#46; Laceraci&#243;n del bronquio intermediario con amputaci&#243;n bronquial y discontinuidad de la v&#237;a a&#233;rea &#40;flecha blanca&#41;&#46;</p>"
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Article information
ISSN: 03002896
Original language: Spanish
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