[Tracheobronchial Injury]

Tracheobronchial injuries (TBIs) are uncommon but potentially life-threatening. TBIs are mainly classified in 2 category, traumatic and iatrogenic. Most common symptoms are dyspnea, subcutaneous emphysema and pneumomediastinum. Pneumothorax is often found in lower tracheal or bronchial injury. Fiberoptic bronchoscopy is most important examination for TBI to detect injured site and its depth. Iatrogenic TBIs are caused by tracheal intubation, tracheostomy and airway intervention. Injury of iatrogenic TBIs are commonly laceration of membranous part. Surgical repair was performed for treatment of iatrogenic TBI. However, recently there has been reported many successful cases of non-operative treatment. Conservative treatment is a considerable choice of treatment. Approach of surgical repair depends on site of tracheal laceration. For laceration of cervical or upper mediastinal trachea, cervical approach is chosen. Recently transcervical-transtracheal repair were reported. Right posterolateral thoracotomy is suitable for repair of carina or main bronchus. Most of TBI caused by blunt trauma occur around carina. Operative treatment is mandatory in many cases. However morbidity and mortality are considerably high in emergent operation for traumatic TBI. It is necessary to make an appropriate strategy for treatment in an experienced trauma center.