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Tracheal/bronchial rupture is a tear or break in the windpipe (trachea) or bronchial tubes, the major airways leading to the lungs. A tear can also occur in the tissue lining the windpipe.

The injury may be caused by:

• Infections
• Sores (ulcerations) due to foreign objects
• Trauma, such as a gunshot wound or automobile accident

Injuries to the trachea or bronchi also may occur during medical procedures (for example, fiberoptic bronchoscopy and placement of a breathing tube). However, this is very uncommon.

Trauma patients who develop a tracheal or bronchial rupture often have other injuries. Patients may:

• Cough up blood
• Develop bubbles of air that can be felt underneath the skin of the chest, neck, arms, and trunk
• Have difficulty breathing

• Chest CT scan
• Chest x-ray
• Fiberoptic bronchoscopy

People who have had a trauma will need to have their injuries treated. Injuries to the trachea often need to be repaired during surgery. Injuries to the smaller bronchi can sometimes be treated without surgery. A collapsed lung is treated with a chest tube connected to suction, which re-expands the lung.

For patients who have breathed a foreign body into the airways, rigid or fiberoptic bronchoscopy may be used to take out the object.

Antibiotics are used in patients with an infection in the part of the lung around the injury.

For trauma patients, the outlook depends on the severity of other injuries. Operations to repair these injuries often have good results. The outlook is good for people whose tracheal or bronchial disruption is due to other causes.

In the months or years after the injury, scarring at the injury site may cause problems that require other tests or procedures.

Major complications after surgery for this condition include:

• Infection
• Long-term need of a ventilator
• Scarring

Contact your health care provider if you have:

• Had a major injury to the chest
• Inhaled a foreign body
• Symptoms of a chest infection

Torn tracheal mucosa

Updated by: Benjamin Medoff, MD, Assistant Professor of Medicine, Harvard Medical School, Pulmonary and Critical Care Unit, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.