Andrés David De León Murillo, Luis Eduardo Garcia Peñaloza
Penetrating tracheobronchial injuries (TBIs) are highly lethal emergencies that pose a critical challenge in low-resource settings due to the lack of advanced imaging. We report the case of a male patient with a knife impaled in the right posterior thorax who presented with dyspnea, hemoptysis, and subcutaneous emphysema. Due to the clinical suspicion of an airway injury and the inability to perform a computed tomography (CT) scan, the patient was immediately transferred to the operating room guided by basic radiographs; via a right thoracotomy, the sharp object was safely extracted, and primary repair of a right main bronchus transection was successfully achieved. This case demonstrates that a high index of clinical suspicion and prompt surgical exploration bypass the need for complex preoperative studies, ensuring lung preservation and an excellent postoperative outcome.