RT Book, Section A1 DuBose, Joseph J. A1 Scalea, Thomas M. A1 O’Connor, James V. A2 Feliciano, David V. A2 Mattox, Kenneth L. A2 Moore, Ernest E. SR Print(0) ID 1175133745 T1 Trachea, Bronchi, and Esophagus T2 Trauma, 9e YR 2020 FD 2020 PB McGraw Hill PP New York, NY SN 9781260143348 LK accesssurgery.mhmedical.com/content.aspx?aid=1175133745 RD 2024/03/28 AB KEY POINTSInjury to Trachea and BronchiDirect laryngoscopy, video laryngoscopy, bronchoscopic-guided intubation, and a surgical airway are all methods to establish a secure airway in a patient with a tracheal injury.The classic presentation of a distal tracheal or proximal bronchial injury is a large pneumothorax and a significant air leak and/or persistent pneumothorax following insertion of a thoracostomy tube.The distal half of the trachea, the right mainstem bronchus, and the proximal left mainstem bronchus are best approached through a right posterolateral thoracotomy.During repair of a mainstem bronchus, a single-lumen endotracheal tube in the contralateral mainstem bronchus allows for ventilation and an easier repair.Tracheal repair is accomplished with interrupted absorbable sutures.Injury to EsophagusThe accuracy of combining a contrast esophagram and esophagoscopy approaches 100%.As opposed to the trachea, the blood supply to the esophagus courses longitudinally in the submucosa, allowing for full mobilization.The extent of the mucosal defect is exposed by incising the muscular layer until both ends of the mucosal tear are visualized.A tension-free esophageal repair is performed in two layers, with absorbable sutures on the mucosa and permanent interrupted sutures on the muscular layer.A vascularized intercostal muscle pedicle is ideal to buttress a repair of the thoracic esophagus.