Objective - To verify the incidence of the wounds of the pulmonary hilum in a public hospital Emergency Unit, and the mortality rate. Means of access, operative techniques and tatics of operation used were also evaluated. Patients and methods - One thousand, one hundred and twenty-four patients with chest trauma were registered at the thoracic surgery unit from April, 1992 to October, 1996. A hundred eighty-two thoracotomies (16.19%) were performed and indication for lung resection was present in only four cases (2.20%). Results - The way of access most commonly used was anterolateral, in three cases, and posterolateral in another case. Two lobectomies and one pneumonectomy were performed. In only one patient a clamping of the hilum was utilized, but the patient died due to massive bleeding. Two other patients died in a total of three deaths. There was only one survivor in this series, who did not present any complication. Conclusion - A low incidence of indication for lung resections was observed in trauma, however, mortality was extremely high due to the lesion involving a high life risk. The most commonly used access was the anterolateral because of the short time needed to clamp the pulmonary hilum, and it was used for all cases of success.

Keywords: Thoracic trauma. Lobectomy. Pneumonectomy.

Two cases of complete bronchial rupture and one case of tracheobronchial rupture by blunt chest trauma were treated at the Thoracic Surgical and Respiratory Endoscopy Department of the Hospital Universitário Cajuru in a period of 2 years. The surgical technique used was end-to-end anastomosis with interrupt absorbable suture after either resection of the stenotic edges or debridement of the lacerated edges. All three patients have had good recovery. The mean period to remove the chest tubes was 3.6 days, and the mean period of discharge from the Thoracic Surgical Department was 5.6 days. The follow-up was made using chest X-ray (PA and lateral projections), lung function tests, and bronchoscopy.

Keywords: Tracheobronchial rupture. Blunt chest trauma. Evaluation. Treatment.