Tracheobronchial injury

Tracheobronchial injury
Reconstruction of the trachea and bronchi with x-ray computed tomography showing disruption of the right main bronchus with abnormal lucency (arrow)[1]
SpecialtyEmergency medicine

Tracheobronchial injury is damage to the tracheobronchial tree (the airway structure involving the trachea and bronchi).[2] It can result from blunt or penetrating trauma to the neck or chest,[3] inhalation of harmful fumes or smoke, or aspiration of liquids or objects.[4]

Though rare, TBI is a serious condition; it may cause obstruction of the airway with resulting life-threatening respiratory insufficiency.[2] Other injuries accompany TBI in about half of cases.[5] Of those people with TBI who die, most do so before receiving emergency care, either from airway obstruction, exsanguination, or from injuries to other vital organs. Of those who do reach a hospital, the mortality rate may be as high as 30%.[6]

TBI is frequently difficult to diagnose and treat.[7] Early diagnosis is important to prevent complications, which include stenosis (narrowing) of the airway, respiratory tract infection, and damage to the lung tissue. Diagnosis involves procedures such as bronchoscopy, radiography, and x-ray computed tomography to visualize the tracheobronchial tree. Signs and symptoms vary based on the location and severity of the injury; they commonly include dyspnea (difficulty breathing), dysphonia (a condition where the voice can be hoarse, weak, or excessively breathy), coughing, and abnormal breath sounds. In the emergency setting, tracheal intubation can be used to ensure that the airway remains open. In severe cases, surgery may be necessary to repair a TBI.[3]

  1. ^ Cite error: The named reference Guen07 was invoked but never defined (see the help page).
  2. ^ a b Cite error: The named reference Chu02 was invoked but never defined (see the help page).
  3. ^ a b Cite error: The named reference Johnson08 was invoked but never defined (see the help page).
  4. ^ Stark P (1995). "Imaging of tracheobronchial injuries". Journal of Thoracic Imaging. 10 (3): 206–19. doi:10.1097/00005382-199522000-00006. PMID 7674433. S2CID 9683995.
  5. ^ Barmada H, Gibbons JR (July 1994). "Tracheobronchial injury in blunt and penetrating chest trauma". Chest. 106 (1): 74–8. doi:10.1378/chest.106.1.74. PMID 8020323.
  6. ^ Cite error: The named reference Moore04 was invoked but never defined (see the help page).
  7. ^ Tovar JA (February 2008). "The lung and pediatric trauma". Seminars in Pediatric Surgery. 17 (1): 53–9. doi:10.1053/j.sempedsurg.2007.10.008. PMID 18158142.