Abstract
Tracheobronchial injuries are an unusual clinical entity accounting for 0.2–8 % of all cases of blunt chest trauma. Actually, most patients die before arriving at the emergency department, from either associated injuries to vital structures, hemorrhage, tension pneumothorax, or respiratory insufficiency from an airway injury. Signs and symptoms may be very subtle or nonspecific and therefore clinical diagnosis is easily overlooked. In this chapter, the authors will review the radiological and CT signs of acute tracheobronchial injuries. Furthermore, mechanism of injury, terminology, and clinical issues will be discussed. Finally, management notes and treatment will be illustrated.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Balci AE, Kazez A, Eren S, Ayan E, Ozalp K, Eren MN (2004) Blunt chest trauma in children: review of 137 cases. Eur J Cardiothorac Surg 26:387–392
Barbick B, Cothren CC, Zimmerman MA, Moore EE (2005) Posttraumatic pneumatocele. J Am Coll Surg 200(2):306–307
Baugartner F, Shepperd B, De Virgilio C et al (1990) Tracheal and main bronchial disruptions after blunt chest trauma: presentation and management. Ann Thorac Surg 50:569–574
Baumgartner FJ, Ayres B, Theuer C (1997) Danger of false intubation after traumatic tracheal transection. Ann Thorac Surg 63:227–228
Burack JH, Kandil E, Sawas A, O'Neill PA, Sclafani SJ, Lowery RC, Zenilman ME (2007) Triage and outcome of patients with mediastinal penetrating trauma. Ann Thorac Surg 83(2):377–382
Cassada DC, Munyikwa MP, Moniz MP, Dieter RA Jr, Schuchmann GF, Enderson BL (2000) Acute injuries of the trachea and main bronchi: importance of early diagnosis. Ann Thorac Surg 69:1563–1567
Chen D, Han L, Hu Y, Yin H, Zhao H, Li H (2001a) Diagnosis and treatment of bronchial rupture from blunt thoracic trauma. Chin Med J (Engl) 114:540–541
Chen JD, Shanmuganathan K, Mirvis SE, Killen KL, Dutton RP (2001b) Using CT to diagnose tracheal rupture. AJR Am J Roentgenol 176:1273–1280
Conti M, Pougeoise M, Wurtz A, Porte H, Fourrier F, Ramon P, Marquette CH (2006) Management of postintubation tracheobronchial ruptures. Chest 131:412–418
Demir A, Olcmen A, Kara HV, Dincer SI (2006) Delayed diagnosis of a complete bronchial rupture after blunt thoracic trauma. Thorac Cardiovasc Surg 54:560–562
Dougenis D (2002) Trauma of the tracheobronchial tree. Arch Hellen Med 19:258–269
Grant WJ, Mayers RL, Jaffe RL, Johnson DG (1998) Tracheobronchial injuries after blunt chest trauma in children –hidden pathology. J Pediatr Surg 33(11):1707–1711
Huth J, Milliken JC, Chen JC (1997) Management of tracheobronchial injuries following blunt and penetranting trauma. Am Surg 63(10):896–899
Jougon J, Ballester M, Choukroun E, Dubrez J, Reboul G, Velly JF (2000) Conservative treatment of postintubation tracheobronchial rupture. Ann Thorac Surg 69:216–220
Karmy-Jones R, Wood DE (2007) Traumatic injury to the trachea and bronchus. Thorac Surg Clin 17:35–46
Kiser AC, O’Brien SM, Detterbeck FC (2001) Blunt tracheobronchial injuries: treatment and outcomes. Ann Thorac Surg 71:2059–2065
Lamp L (2004) Tracheobronchial injuries. Conservative management. Interact Cardiovasc Thorac Surg 3:401–405
Lupetin AR (1997) Computed tomographic evaluation of laryngotracheal trauma. Curr Probl Diagn Radiol 26:185–206
Marty-Ane CH, Picard E, Jonquet O, Mary H (1995) Membranous tracheal rupture after endotracheal intubation. Ann Thorac Surg 60:1367–1371
Massard G, Rouge C, Dabbagh A et al (1996) Tracheobronchial lacerations after intubation and tracheostomy. Ann Thorac Surg 61:1483–1487
Milner A (2008) The airway in face, head, and neck injury. SAJAA 14:52–57
Nelson LA (2007) Airway trauma. Int Anesthesiol Clin 45:99–118
OH KS, Fleischner FG, Wyman SM (1969) Characteristic pulmonary finding in traumatic complete transection of a main-stem bronchus. Radiology 92:371–372
Paraschiv M (2014) Iatrogenic tracheobronchial rupture. J Med Life 7(3):343–348
Polansky A, Resnick D, Sofferman RA, Davidson TM (1984) Hyoid bone elevation: a sign of tracheal transection. Radiology 150:117–120
Rathlev NK, Mezdon R, Bracken ME (2007) Evaluation and management of neck trauma. Emerg Med Clin North Am 25:679–694
Riley RD, Miller PR, Meredith JW (2004) Injury to the esophagus, trachea and bronchus. In: Moore EE, Feliciano DV, Mattox K (eds) Trauma, 5th edn. McGraw-Hill, New York, pp 539–552
Rollins RJ, Tocino I (1987) Early radiographic signs of tracheal rupture. AJR Am J Roentgenol 148(4):695–698
Savas R, Alper H (2008) Fallen lung sign: radiographic findings. Diagn Interv Radiol 14:120–121
Scaglione M, Pinto A, Romano L (2002) Traumi chiusi del torace. Gnocchi, Napoli
Scaglione M, Romano S, Rotondo A (2006) Acute tracheobronchial injuries: impact of imaging on diagnosis and management implications. Eur J Radiol 59:336–343
Schneider T, Storz K, Dienemann H, Hoffmann H (2007) Management of iatrogenic tracheobronchial injuries: a retrospective analysis of 29 cases. Ann Thorac Surg 83:1960–1964
Stark P (1995) Imaging of tracheobronchial injuries. J Thorac Imaging 10:206–219
Wiot JF (1983) Tracheobronchial trauma. Semin Roentgenol 18:15–22
Wong EH, Knight S (2006) Tracheobronchial injuries from blunt trauma. ANZ J Surg 76:414–415
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Scaglione, M. et al. (2016). Acute Tracheobronchial Injuries. In: Scaglione, M., Linsenmaier, U., Schueller, G., Berger, F., Wirth, S. (eds) Emergency Radiology of the Chest and Cardiovascular System. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/174_2016_40
Download citation
DOI: https://doi.org/10.1007/174_2016_40
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-42582-5
Online ISBN: 978-3-319-42584-9
eBook Packages: MedicineMedicine (R0)