Tracheal diverticulum
Updates to Article Attributes
Tracheal diverticula isare usually an incidental finding. Occasionally it may mimic pneumomediastinum, so-called pseudopneumomediastinum.
PathologyTerminology
It may be congenital or acquired. The acquired formThere is thoughtoverlap in the use and description of the terms paratracheal air cyst and tracheal diverticulum in the literature that they often seem to be due to synonyms for the same entity 1,5.
Clinical presentation
Tracheal diverticula are typically asymptomatic but can occasionally present with chronic cough, stridor, dyspnoea or recurrent infection 5.
Pathology
Tracheal diverticula can be 5:
- congenital
-
acquired
- prolonged
increasedincrease intraluminal pressure, e.g.due to achronic cough, COPD - tracheomalacia
- iatrogenic, e.g. post-surgical
- prolonged
Location
It projects posteriorly where the cartilage rings are deficient and usually lies to the right where there is no oesophagus supporting the paratracheal tissue. TypicallyThe vast majority (97%) are located into the right posterolateral tracheal wallaspect of the trachea, about the level of the thoracic inlet5. A direct connection with the trachea is often visiblemay not always be shown on CT5.
Associations
-
chronic obstructive pulmonary disease (COPD)
3 - tracheobronchomegaly: when multiple tracheal diverticula are present 5
Complications
Although usually asymptomatic, it may accumulate respiratory secretions that become infected (and potentially abscess-forming) and lead to coughing or tracheobronchitis.
Differential diagnosis
The differential diagnosis of a paratracheal air cyst also includes an oesophageal diverticulum and an apical bleb or bulla, e.g.
See also
-<p>A <strong>tracheal diverticulum</strong> is usually an incidental finding. Occasionally it may mimic <a href="/articles/pneumomediastinum">pneumomediastinum</a>, so-called <a href="/articles/pseudopneumomediastinum">pseudopneumomediastinum</a>.</p><h4>Pathology</h4><p>It may be congenital or acquired. The acquired form is thought to be due to prolonged increased intraluminal pressure, e.g. due to a chronic cough. </p><h5>Location</h5><p>It projects posteriorly where the cartilage rings are deficient and usually lies to the right where there is no oesophagus supporting the paratracheal tissue. Typically located in the right posterolateral tracheal wall about the level of the thoracic inlet. A direct connection with the trachea is often visible on CT. </p><h5>Associations</h5><ul><li>-<a href="/articles/chronic-obstructive-pulmonary-disease-1">chronic obstructive pulmonary disease (COPD) </a><sup>3</sup>: for acquired type</li></ul><h4>Complications</h4><p>Although usually asymptomatic, it may accumulate respiratory secretions that become infected and lead to coughing or tracheobronchitis. </p><h4>Differential diagnosis</h4><p>The differential diagnosis of a paratracheal air cyst also includes an oesophageal diverticulum and an apical bleb or bulla, e.g.</p><ul>- +<p><strong>Tracheal diverticula</strong> are usually an incidental finding. Occasionally it may mimic <a href="/articles/pneumomediastinum">pneumomediastinum</a>, so-called <a href="/articles/pseudopneumomediastinum">pseudopneumomediastinum</a>.</p><h4>Terminology</h4><p>There is overlap in the use and description of the terms <strong>paratracheal air cyst</strong> and <strong>tracheal diverticulum</strong> in the literature that they often seem to be synonyms for the same entity <sup>1,5</sup>. </p><h4>Clinical presentation</h4><p>Tracheal diverticula are typically asymptomatic but can occasionally present with chronic cough, stridor, dyspnoea or recurrent infection <sup>5</sup>. </p><h4>Pathology</h4><p>Tracheal diverticula can be <sup>5</sup>:</p><ul>
- +<li>congenital</li>
- +<li>acquired<ul>
- +<li>prolonged increase intraluminal pressure, e.g. chronic cough, COPD</li>
- +<li>tracheomalacia</li>
- +<li>iatrogenic, e.g. post-surgical</li>
- +</ul>
- +</li>
- +</ul><h5>Location</h5><p>It projects posteriorly where the cartilage rings are deficient and usually lies to the right where there is no oesophagus supporting the paratracheal tissue. The vast majority (97%) are located to the right posterolateral aspect of the trachea, about the level of the thoracic inlet <sup>5</sup>. A direct connection with the trachea may not always be shown on CT <sup>5</sup>. </p><h5>Associations</h5><ul>
- +<li>
- +<a href="/articles/chronic-obstructive-pulmonary-disease-1">chronic obstructive pulmonary disease (COPD)</a>: for acquired type <sup>3</sup>
- +</li>
- +<li>
- +<a href="/articles/mounier-kuhn-syndrome">tracheobronchomegaly</a>: when multiple tracheal diverticula are present <sup>5</sup>
- +</li>
- +</ul><h4>Complications</h4><p>Although usually asymptomatic, it may accumulate respiratory secretions that become infected (and potentially abscess-forming) and lead to coughing or tracheobronchitis. </p><h4>Differential diagnosis</h4><ul>
References changed:
- 5. Tanrivermis Sayit A, Elmali M, Saglam D, Celenk C. The Diseases of Airway-Tracheal Diverticulum: A Review of the Literature. J Thorac Dis. 2016;8(10):E1163-7. <a href="https://doi.org/10.21037/jtd.2016.10.92">doi:10.21037/jtd.2016.10.92</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/27867581">Pubmed</a>
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