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.

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.