Tracheobronchial injury is one of cases which are relatively uncommon, but must be suspected to make the diagnosis and managed immediately. In such a case, primary initial goals are to stabilize the airway and localize the injury and then determine its extend. These can be possible mostly with flexible bronchoscopy conducted by a surgeon who can repair the injury. Most of the penetrating
injuries occur in the cervical region. On the other hand, most of the
blunt injuries occur in the distal trachea and right main bronchus and they can be best approached by right posterolateral
thoracotomy. The selection of the manner and time of approaching depends on the existence and severity of additional
injuries. Most of the
injuries can be restored by deploying simple techniques such as individual
sutures, while some of them requires complex reconstruction techniques. Apart from paying attention to the pulmonary
toilet, follow-up is crucial for determination of anastomotic technique or
stenosis.
Conservative treatment may be considered an option with a high probability of success in patients meeting the criteria, especially in patients with iatrogenic tracheobronchial injury.