Tracheobronchomalacia

  • Etiology: primary (congenital) or secondary (acquired due to vascular ring, infection / inflammation, trauma, esophageal atresia dilated proximal pouch)
  • Imaging: collapse of airway during respiration, on CT imaged during expiration or without positive end expiratory pressure a ratio of minor axis / major axis of less than 0.7 suggests tracheobronchomalacia
  • Clinical: most common congenital anomaly of trachea

Cases of Tracheobronchomalacia

Upper GI of esophageal atresia with distal tracheo-esophageal fistula
CXR AP (left) shows a nasogastric tube that cannot be advanced further in the esophagus. Vintage upper GI lateral image (right) shows a dilated proximal esophageal pouch compressing the airway. In current practice, there is no indication for doing an upper GI with positive contrast material.