Incidental Tracheocele as an Unusual Presentation of Pneumomediastinum in the Trauma Setting

Patient: Female, 25-year-old Final Diagnosis: Tracheocele Symptoms: Asymptomatic Medication:— Clinical Procedure: Computed tomography • flexible laryngoscopy/bronchoscopy Specialty: Otolaryngology OBJECTIVE: Rare disease BACKGROUND: Tracheocele are rarely encountered air cysts formed due to tracheal wall outpouching through a weak vantage point. The majority are acquired in the adult population and are associated with conditions that weaken the tracheal wall. Most tracheoceles are diagnosed incidentally since many are asymptomatic or present with non-specific symptoms. Multidetector computed tomography (MDCT) scans are the most common imaging modality for diagnosis of silent tracheal cysts. Tracheocele have been very rarely documented in the trauma setting; therefore, in the setting of multiple body trauma diagnosis can be challenging. CASE REPORT: We report a case of an acquired tracheocele after a high-impact blunt thoracic trauma with an admission diagnosis of suspected tracheal perforation. MDCT of the neck and chest demonstrated an irregularly multicystic-shaped air collection at the right posterolateral trachea upon evaluation. Flexible laryngoscopy and bronchos-copy results were unremarkable. CONCLUSIONS: Tracheocele are rare and asymptomatic pseudo-diverticulum of the tracheal wall. Many are diagnosed incidentally with imaging studies for other conditions. Nevertheless, in the trauma setting its diagnosis can be challenging and misleading. Consideration of conditions such as tracheocele is important to prevent any unwar-ranted treatment modalities.