|
Tracheal/bronchial rupture |
| Definition: |
| A tear or breakage of the trachea or bronchus portion of the respiratory tract. Causes may include: infections, ulcerations due to foreign objects, and trauma. Torn tracheal mucosa is a disruption of the windpipe tissue lining. |
| Alternative Names: |
| Torn tracheal mucosa |
| Causes, incidence, and risk factors: |
|
Disruption of the trachea and bronchi may occur after penetrating (e.g., gunshot wound) or blunt (e.g., automobile accident) trauma, but these are uncommon injuries. Injuries to the trachea or bronchi may occur during medical procedures (e.g., fiberoptic bronchoscopy, placement of endotracheal breathing tube), but this is also very uncommon. Aspiration of a foreign body (e.g., food) into the trachea or bronchi may produce infection and erosion through the wall, producing a disruption. |
| Symptoms: |
|
Trauma patients who develop a tracheal/bronchial rupture often have evidence of other injuries as well. Patients may have difficulty breathing, may cough up blood or other secretions, and may develop subcutaneous air -- bubbles of air that can be felt underneath the skin of the chest, neck, arms, and trunk. |
| Signs and tests: |
|
The chest X-ray may show collapse of the lung or evidence of infection. The chest CT scan may show similar findings. Fiberoptic bronchoscopy can show the exact extent and location of disruption of the trachea or bronchi. |
| Treatment: |
|
For trauma patients, other injuries will require simultaneous treatment. Injuries to the trachea often require operation for repair. Injuries to the smaller bronchi, especially if there is less than total disruption, can sometimes be treated expectantly, without operation. Lung collapse is treated with a chest tube, connected to suction, that re-expands the lung. For patients with aspiration of foreign bodies, rigid or fiberoptic bronchoscopy may be used to retrieve the object. For patients with infection in the part of the lung surrounding the injury, antibiotics are used. |
| Expectations (prognosis): |
|
For trauma patients, the prognosis depends on the extent of other injuries. Operation for repair of these injuries often produces a good result. The prognosis is good for patients with other causes of tracheal or bronchial disruption. Problems with scarring at the site of injury may lead to difficulties in the months or years after injury and may require additional diagnostic tests or procedure. |
| Complications: |
|
Major complications after operations for this injury include: infection, prolonged need for the use of a ventilator, and scarring. |
| Calling your health care provider: |
|
Patients with major injuries to the chest, aspiration of foreign bodies, or signs and symptoms of chest infection should notify their physician. |
| Prevention: |
|
These injuries cannot be prevented. |
Reviewed By: Lawrence L. Creswell, M.D., Division of Cardiothoracic Surgery, Washington University School of Medicine and Barnes-Jewish Hospital, St. Louis, MO. Review provided by VeriMed Healthcare Network.
 |
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch). |
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2003 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
