ABSTRACT
David Hume, a Scottish philosopher, remarked that a wise man proportions his belief to the evidence. In the case of traumatic injuries to the esophagus and tracheobronchial tree, the evidence consists mostly of case reports, retrospective analyses, and opinions. The rarity of these injuries has prevented the accumulation of significant prospective data. This chapter covers incidence, mechanism of injury, and current practices in diagnosing and managing these rare injuries. It may not strengthen the wise physician's beliefs, but it accurately reflects the current evidence. Autopsy studies of blunt trauma patients reveal an incidence of tracheobronchial injury in 2.8% of fatalities. Series that include data on symptomatology and physical findings report the most common symptom as respiratory distress and the most common physical finding as subcutaneous emphysema. Certain patients with airway injury will have obvious findings on the physical exam such as air bubbling from a penetrating neck wound.
