Traumatic Injury to the Trachea and Bronchus

Tracheobronchial injuries are uncommon, occurring in as few as 0.5% of patients who present following injury. The incidence may be as high as 8%, however, following penetrating neck injury, and 2% following blunt chest or cervical injury. They often present as immediately life-threatening injuries, but may present in a more occult fashion with late onset of hemoptysis, recurrent pneumonia, or “asthma.” Diagnosis often requires a high degree of clinical suspicion. Management must be immediately directed to securing the airway, which may require advanced bronchoscopic skills. Subsequent repair must take into account the severity of associated injuries and exact location and degree of airway disruption.