Tracheal rupture

  • Definition
    • A tracheal or bronchial rupture is a tear or break in the windpipe (trachea) or bronchial tubes, the major airways leading to the lungs. A tear can also occur in the tissue lining the windpipe.

  • Alternative Names
    • Torn tracheal mucosa; Bronchial rupture

  • Causes
    • The injury may be caused by:

      • Infections
      • Sores (ulcerations) due to foreign objects
      • Trauma, such as a gunshot wound or automobile accident

      Injuries to the trachea or bronchi also may occur during medical procedures (for example, fiberoptic bronchoscopy and placement of a breathing tube). However, this is very uncommon.

  • Symptoms
    • Trauma patients who develop a tracheal or bronchial rupture often have other injuries. Patients may:

      • Cough up blood
      • Develop bubbles of air that can be felt underneath the skin of the chest, neck, arms, and trunk
      • Have difficulty breathing
  • Exams and Tests
  • Treatment
    • People who have had a trauma will need to have their injuries treated. Injuries to the trachea often need to be repaired during surgery. Injuries to the smaller bronchi can sometimes be treated without surgery. A collapsed lung is treated with a chest tube connected to suction, which re-expands the lung.

      For patients who have breathed a foreign body into the airways, rigid or fiberoptic bronchoscopy may be used to take out the object.

      Antibiotics are used in patients with an infection in the part of the lung around the injury.

  • Outlook (Prognosis)
    • For trauma patients, the outlook depends on the severity of other injuries. Operations to repair these injuries often have good results. The outlook is good for people whose tracheal or bronchial disruption is due to causes such as a foreign object, which tend to have a good outcome.

      In the months or years after the injury, scarring at the injury site may cause problems that require other tests or procedures.

  • Possible Complications
    • Major complications after surgery for this condition include:

      • Infection
      • Long-term need of a ventilator
      • Narrowing of the airways
      • Scarring
  • When to Contact a Medical Professional
    • Contact your health care provider if you have:

      • Had a major injury to the chest
      • Inhaled a foreign body
      • Symptoms of a chest infection
      • The feeling of "air bubbles" underneath your skin and trouble breathing
  • References
    • Kraft M. Approach to the patient with respiratory disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 83.

      Kupeli E, Karnak D, Mehta AC. Flexible bronchoscopy. In: Mason RJ, Broaddus CV, Martin TR, et al, eds. Textbook of Respiratory Medicine. 5th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 22.