Radiology quiz case 1. Tracheocele

Infected tracheocoele (acquired tracheal diverticulum): case report and literature review

BACKGROUND

Paratracheal air-filled cysts are rare. Tracheocoele or acquired tracheal diverticulum is the term given to these acquired abnormalities, which usually arise in adults. The majority is asymptomatic, being discovered as incidental findings on radiological imaging.

METHODS

We report the case of a 72-year-old man with a previously identified tracheocoele which became symptomatic following an upper respiratory tract infection. A literature is presented and nomenclature is discussed.

RESULTS

The clinical presentation, differential diagnosis and management of paratracheal air-filled cysts are discussed.

CONCLUSION

While most of these rare abnormalities are discovered incidentally, this case illustrates the fact that significant symptoms can develop; excision should therefore be considered.

Endoscopic treatment of tracheocele in pediatric patients

Acquired tracheal pouch known also as tracheocele is a rare air-filled diverticulum of tracheal pars membranacea. This disease may be due to esophageal or tracheal surgery, orotracheal intubation, or increased intralunimal pressure through a weak area of tracheal wall. When symptomatic and medical therapy is insufficient, this disorder must be treated surgically. Several surgical methods ranging from open neck or thoracic surgery to endoscopic managements have been reported. We report the case history of a 7-year-old boy affected by recurrent pneumonia due to tracheal pouch. The patient underwent successful brushing of tracheocele plus fibrin glue application by rigid tracheobroncoscopy. Furthermore, particular emphasis on endoscopic treatments of tracheal diverticulum is also presented.