According to Teach Me Anatomy ( 2020), “the tracheobronchial tree is composed of the trachea, bronchi and bronchioles. It is a system of airways that allows passage of air into the lungs where gas exchange occurs. These airways are in the neck and thorax” (Paragraph 1). A tracheobronchial tear is a rare and life-threatening injury related to blunt trauma to the distal trachea that involves a partial or complete tear, or a puncture of the tracheal or bronchial wall. These injuries can be caused by trauma or iatrogenically (caused during an invasive procedure). Common symptoms include difficulty breathing, subcutaneous emphysema, and pneumomediastinum. A pneumothorax is often found in a lower tracheal or bronchial injury. Patients who have a tracheobronchial tear tend to have a rib fracture, which may cause the lacerations. Often, multiple chest injuries and other body regions are affected.
Iatrogenic tracheobronchial injuries are caused by intubation, tracheostomy, and airway intervention. Common tears occur in the membranous sections. Surgical repair is the best form of treatment depending on the site of the tracheal laceration. A chest X-ray is the initial diagnostic procedure; however, a chest CT is preferred if a tracheobronchial tear is suspected. The definitive diagnostic procedure is a bronchoscopy or surgical exploration to assess the injured site and depth. A tracheobronchial tear increases the risk for disease and death.
References
Di Muzio, B. (2020). Tracheobronchial Injury. https://radiopaedia.org/articles/tracheobronchial-injury
Grewal, H. S., Dangayach, N. S., Ahmad, U., Ghosh, S., Gildea, T., & Mehta, A. C. (2019). Treatment of Tracheobronchial Injuries: A Contemporary Review. CHEST, 155(3), 595–604. https://doi.org/10.1016/j.chest.2018.07.018.
Kosaka, S. (2015). Tracheobronchial Injury. Kyobu Geka. The Japanese Journal of Thoracic Surgery, 68(8), 660–664.
Smith, K.M. (2020). [Photo]. Colored model of tracheobronchial tree front view and back view isolated on black. https://www.shutterstock.com/image-photo/colored-model-tracheobronchial-tree-front-view-128692940
Teach Me Anatomy. (2020). The Tracheobronchial Tree. https://teachmeanatomy.info/thorax/organs/tracheobronchial-tree/.