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Tracheobronchial injury is a serious but uncommon manifestation of chest trauma. It is usually a fatal injury with only a small percentage of patients making it to hospital. Given the magnitude of force required to injure the major airways, there are often multiple chest and other bodily injuries.
The cervical trachea is the most injured site in penetrating injury 3, whereas injury to the distal trachea (within 2.5 cm of the carina) is seen most commonly following blunt chest trauma 4. The site of injury can be identified in 70% of patients with CT 7.
subcutaneous emphysema in the chest and/or neck
endotracheal tube balloon
herniation into the airway defect
Features include 6:
disruption of the tracheal or bronchial cartilage rings
irregularity of the airway wall
focal thickening of the tracheal or bronchial wall
massive pneumomediastinum (sometimes despite appropriate pleural space decompression with intercostal catheters)
fallen lung sign: rare
If left untreated, late complications can occur such as 9: