tracheal diverticulum

Tracheal diverticula, also known as tracheoceles, are usually an incidental finding. Occasionally it may mimic pneumomediastinum, so-called pseudopneumomediastinum.

Terminology

There is an overlap in the use and description of the terms paratracheal air cyst and a tracheal diverticulum in the literature that they often seem to be synonyms for the same entity .

Clinical presentation

Tracheal diverticula are typically asymptomatic but can occasionally present with chronic cough, stridor, dyspnea, or recurrent infection .

Pathology

Tracheal diverticula can be :

  • congenital
  • acquired
    • prolonged increase intraluminal pressure, e.g. chronic cough, COPD
    • tracheomalacia
    • iatrogenic, e.g. post-surgical
Location

It projects posteriorly where the cartilage rings are deficient and usually lies to the right where there is no esophagus supporting the paratracheal tissue . The vast majority (97%) are located to the right posterolateral aspect of the trachea, about the level of the thoracic inlet . A direct connection with the trachea may not always be shown on CT .

Associations

Treatment and prognosis

Although usually asymptomatic, it may accumulate respiratory secretions that become infected (and potentially abscess-forming) and lead to coughing or tracheobronchitis.

Differential diagnosis