Tracheal diverticulum
Last revised by Daniel J Bell on 21 Mar 2024
Citation, DOI, disclosures and article data
Citation:
Dawes L, Bell D, Elfeky M, et al. Tracheal diverticulum. Reference article, Radiopaedia.org (Accessed on 19 Apr 2024) https://doi.org/10.53347/rID-2188
Permalink:
rID:
2188
Article created:
2 May 2008,
Laughlin Dawes
Disclosures:
At the time the article was created Laughlin Dawes had no recorded disclosures.
View Laughlin Dawes's current disclosures
Last revised:
21 Mar 2024,
Daniel J Bell ◉
Disclosures:
At the time the article was last revised Daniel J Bell had no financial relationships to ineligible companies to disclose.
View Daniel J Bell's current disclosures
Revisions:
24 times, by
15 contributors -
see full revision history and disclosures
Systems:
Synonyms:
- Tracheal diverticula
- Diverticulum of trachea
- Tracheocele
- Tracheoceles
- Tracheocoele
- Tracheocoeles
Tracheal diverticula, also known as tracheoceles, are usually an incidental finding. Occasionally they may mimic pneumomediastinum, a so-called pseudopneumomediastinum.
On this page:
Terminology
There is an overlap in the use and description of the terms paratracheal air cyst and a tracheal diverticulum in the literature such that they often seem to be synonyms for the same entity, which they are not 1,5.
Epidemiology
Associations
chronic obstructive pulmonary disease (COPD): for acquired type 3
tracheobronchomegaly: when multiple tracheal diverticula are present 5
Clinical presentation
Tracheal diverticula are typically asymptomatic but can occasionally present with chronic cough, stridor, dyspnea, or recurrent infection 5.
Pathology
Tracheal diverticula can be 5:
congenital
-
acquired
prolonged increased intraluminal pressure, e.g. chronic cough, COPD
iatrogenic, e.g. post-surgical
Location
A tracheal diverticulum projects posteriorly where the cartilage rings of the trachea are deficient and usually lies to the right where there is no esophagus supporting the paratracheal tissue 6. The vast majority (97%) are located at the right posterolateral aspect of the trachea, approximately at the level of the thoracic inlet 5. A direct connection with the trachea may not always be appreciable on CT 5.
Treatment and prognosis
Although usually asymptomatic, tracheal diverticula may accumulate respiratory secretions that become infected (and potentially abscess-forming) and lead to coughing or tracheobronchitis.
History and etymology
In 1838, Rokitansky described three cases of tracheal diverticula for the first time 7.
Differential diagnosis
Quiz questions
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References
- 1. Buterbaugh J & Erly W. Paratracheal Air Cysts: A Common Finding on Routine CT Examinations of the Cervical Spine and Neck That May Mimic Pneumomediastinum in Patients with Traumatic Injuries. AJNR Am J Neuroradiol. 2008;29(6):1218-21. doi:10.3174/ajnr.A1058 - Pubmed
- 2. Goo J, Im J, Ahn J et al. Right Paratracheal Air Cysts in the Thoracic Inlet: Clinical and Radiologic Significance. AJR Am J Roentgenol. 1999;173(1):65-70. doi:10.2214/ajr.173.1.10397101 - Pubmed
- 3. Webb E, Elicker B, Webb W. Using CT to Diagnose Nonneoplastic Tracheal Abnormalities: Appearance of the Tracheal Wall. AJR Am J Roentgenol. 2000;174(5):1315-21. doi:10.2214/ajr.174.5.1741315 - Pubmed
- 4. Higuchi T, Takahashi N, Shiotani M, Maeda H, Yoshimura N. Characteristics and CT Features of Subcarinal Air Collections/main Bronchial Diverticula. Eur Radiol. 2010;20(1):95-9. doi:10.1007/s00330-009-1526-z - Pubmed
- 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. doi:10.21037/jtd.2016.10.92 - Pubmed
- 6. Pace M, Dapoto A, Surace A et al. Tracheal Diverticula: A Retrospective Analysis of Patients Referred for Thoracic CT. Medicine (Baltimore). 2018;97(39):e12544. doi:10.1097/MD.0000000000012544 - Pubmed
- 7. Mathey J & Lemoine A. Tracheal Diverticulum and Congenital Oesophagotracheal Fistula Without Oesophageal Atresia. Thorax. 1954;9(2):106-11. doi:10.1136/thx.9.2.106 - Pubmed
Incoming Links
Articles:
Cases:
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