Trachea, Bronchus, and Esophagus Injuries: Techniques

Even in the busiest trauma centers, injuries to the tracheobronchial tree and esophagus are relatively rare. They most commonly occur in the neck, as the thoracic cage provides protection in the chest. Prompt recognition and management of tracheobronchial injury remain paramount to optimize outcomes. Compromise of the major airways can restrict oxygenation and ventilation and thus lead to alterations in gas exchange and subsequent hemodynamic compromise. Any sign of major airway injury should lead the trauma team to rapidly search for the anatomic lesion and initiate treatment. Penetrating injury is the predominant cause of esophageal trauma. Blunt injuries to the esophagus remain rare and are often associated with concomitant thoracic injury. Blunt injury occurs as a result of direct force to the cervical esophagus in conjunction with a hyperextended neck or rarely as a result of intraluminal distention secondary to blunt force trauma.