Pulmonology Book


Bronchial Tear

Aka: Bronchial Tear, Bronchial Laceration, Tracheal Laceration, Tracheal Tear
  1. Signs
    1. Hemoptysis
    2. Subcutaneous Emphysema
    3. Tension Pneumothorax
      1. Large, persistent air leak
  2. Imaging
    1. Chest XRay (may show irregular mediastinum)
    2. Chest CT
  3. Diagnostics
    1. Esophogram
    2. Bronchoscopy
    3. Arteriogram
  4. Associated Conditions
    1. Esophageal Injury
    2. Carotid Artery Injury
    3. Jugular Vein Injury
  5. Precautions
    1. Tracheobronchial injury is associated with very high mortality
    2. Typical injury occurs within 1 inch of the carina
    3. Surgical airway management is critical
  6. Management
    1. Anticipate difficult airway management
    2. Emergent surgical intervention

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