The diseases of airway-tracheal diverticulum: a review of the literature

Abstract

Tracheal diverticulum (DV) is a type of paratracheal air cyst (PTAC) that is often asymptomatic and usually detected incidentally by imaging methods. Tracheal DV are divided into two subgroups: congenital and acquired. Dysphagia, odynophagia, neck pain, hoarseness, hemoptysis, choking, and recurrent episodes of hiccups and burping can also be seen in symptomatic patients. Thin-section multidetector computed tomography (MDCT) is useful for diagnosis of tracheal diverticulum. The relationship between DV and tracheal lumen can be demonstrated by axial, coronal, and sagittal reformat multiplanar images. Bronchoscopy can also be used in diagnosis for tracheal DV. However, the connection between DV and tracheal lumen can not be shown easily with bronchoscopy. Conservative treatment is the preferred treatment in asymptomatic patients. Surgical or conservative treatment can be performed for symptomatic patients, depending on patient age and physical condition.

Keywords: Trachea; chronic obstructive pulmonary disease (CODP); diverticulum (DV); multidetector computed tomography; thorax; tracheal diseases.

Figure 1

Contrast-enhanced multidetector computed tomography (MDCT), 1 mm thickness. (A) Axial images of the chest showing air-filled tracheal diverticulum (DV) located at the right posterior paratracheal area (arrow) adjacent to the esophageal lumen (arrowhead) in the mediastinal window. There is no visible communicating channel between the DV and the tracheal lumen; (B) coronal and (C) sagittal reformatted images of the chest show a lobulated multiseptated air-filled tracheal DV (arrow) located at the paratracheal area in the parankim window. In addition, peribronchial wall thickening and mild emphysematous changes are observed in the parenchymal window.

Figure 2

Contrast-enhanced MDCT, 1 mm thickness. The axial images of the chest reveal tracheal DV (arrowhead) at the right posterolateral aspect of the trachea in the (A) mediastinal and (B) lung window. The connection (arrow) between the tracheal lumen is also seen at the posterior wall of the trachea. Coronal (C) reformatted image of the chest demonstrates tracheal DV (arrow) at the posterior of the trachea (arrowhead). MDCT, multidetector computed tomography; DV, diverticulum.