Pediatric Tracheobronchomalacia

  • Etiology:
    — Primary – congenital
    — Secondary – acquired due to vascular ring, infection and inflammation, trauma, esophageal atresia with dilated proximal pouch
  • Imaging Fluoroscopy: Collapse of airway during respiration
  • Imaging CT: When imaged during expiration or without positive end expiratory pressure a ratio of minor axis / major axis of less than 0.7 suggests tracheobronchomalacia
  • DDX:
  • Complications:
  • Treatment:
  • Clinical: Most common congenital anomaly of trachea

Radiology 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.