Cedera trakeobronkial


Cedera trakeobronkial
Rekontruksi dari trakea dan bronkus dilihat menggunakan x-ray tomografi terkomputasi menampilkan gangguan pada bronkus utama dengan daerah bagian gelap yang tidak normal (berbentuk panah)[1]
Informasi umum
SpesialisasiKedaruratan medis

Cedera trakebronkial (atau biasa disingkat TBI dari Bahasa Inggrisnya tracheobronchial injury) adalah kerusakan yang terjadi pada pohon trakeobronkial (struktur jalan nafas yang melibatkan trakea dan bronkus).[2] Kerusakan tersebut dapat berasal dari trauma tumpul atau tajam di bagian leher atau dada,[3] karena menghirup udara, asap, atau uap cairan atau objek yang berbahaya.[4]

Gejala

Pneumothoraks di kedua paru-paru (panah besar), pneumomediastinum (panah kecil) dan emfisema subkutan pada seorang pasien dengan gangguan di bagian bronkus kanannya. Terjadi kebocoran udara terus menerus meski tetap dapat melakukan penghirupan.[1]

Gejala cedera trakeobronkial berbeda-beda pada setiap orang tergantung pada bagian mana orang tersebut terluka dan sebera parah luka tersebut.[5] Ada beberapa gejala yang cukup umum pada penderita cedera trakeobronkial seperti dispnea (kesulitan bernapas) yang ditemukan pada sekitar 76–100% penderita cedera trakeobronkial dan emfisema subkutan yang ditemukan pada hingga 85% penderita cedera trakeobronkial.[6]

Selain itu, juga terdapat gejala yang lebih langka namun lebih spesifik seperti pneumothoraks, dimana paru-paru terjatuh jauh dari mediastinum sebagai akibat dari transeksi bronkial.[7][8] Gejala lain yang tidak terlalu umum adalah batuk darah yang ditemukan pada 25% penderita cedera trakeobronkial.[6]

Pengobatan

Sebuah endotracheal tube yang dapat digunakan sebagai jalan pintas pada gangguan jalan udara

Pengobatan cedera trakeobronkial berbeda-beda tergantung pada gejala dan tingkat keparahan pasien.[2] Karena kebanyakan pasien penderita cedera trakeobronkial akan mengalami kesulitan bernapas, hal pertama yang harus dipastikan adalah kondisi jalan udara pasien.[6] Jika ada gangguan pada jalan udara, intubasi, yang merupakan salah satu cara pengamanan jalan udara, dapat dilakukan untuk mengirim udara ke paru-paru. Jika diperlukan, sebuah tabung dapat diletakkan pada bagian bronkus yang tidak terluka dan salah satu paru-paru dapat dilubangi.[3]

Referensi

  1. ^ a b Le Guen M, Beigelman C, Bouhemad B, Wenjïe Y, Marmion F, Rouby JJ (2007). "Chest computed tomography with multiplanar reformatted images for diagnosing traumatic bronchial rupture: A case report". Critical Care. 11 (5): R94. doi:10.1186/cc6109. PMC 2556736 alt=Dapat diakses gratis. PMID 17767714. Diarsipkan dari versi asli tanggal 2008-02-28. Diakses tanggal 2020-02-14. 
  2. ^ a b Chu CP, Chen PP (2002). "Tracheobronchial injury secondary to blunt chest trauma: Diagnosis and management". Anaesthesia and Intensive Care. 30 (2): 145–52. PMID 12002920. 
  3. ^ a b Johnson SB (2008). "Tracheobronchial injury". Seminars in Thoracic and Cardiovascular Surgery. 20 (1): 52–57. doi:10.1053/j.semtcvs.2007.09.001. PMID 18420127. 
  4. ^ Stark P (1995). "Imaging of tracheobronchial injuries". Journal of Thoracic Imaging. 10 (3): 206–19. doi:10.1097/00005382-199522000-00006. PMID 7674433. 
  5. ^ Riley et al. (2004). pp. 544–7.
  6. ^ a b c Karmy-Jones R, Wood DE (2007). "Traumatic injury to the trachea and bronchus". Thoracic Surgery Clinics. 17 (1): 35–46. doi:10.1016/j.thorsurg.2007.03.005. PMID 17650695. 
  7. ^ Nakayama DK, Rowe MI (1988). "Intrathoracic tracheobronchial injuries in childhood". International Anesthesiology Clinics. 26 (1): 42–9. doi:10.1097/00004311-198802610-00009. PMID 3283046. 
  8. ^ "Chapter 6: Imaging Chest Trauma" (dalam bahasa Inggris). Science Direct. Diakses tanggal 14 Februari 2020. 

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