Saber-sheath trachea as a marker of severe airflow obstruction in chronic obstructive pulmonary disease

Ciccarese, Federica; Poerio, Angela; Stagni, Silvia; Attinà, Domenico; Fasano, Luca; Carbonara, Paolo; Reggiani, Maria Letizia Bacchi; Zompatori, Maurizio

doi:10.1007/s11547-013-0318-3

Cited by 21 publications

(17 citation statements)

References 19 publications

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“…The national prevalence for COPD in the >75-year age group is 29.2%. 10 Given the prevalence of SST in COPD is 25.4%, 9 we expected there would be 3840 occurrences of SST in the >75-year age group. In fact, in the >75-year group, only 92 reports contained the SST phrase, a reporting rate of 2.4%.…”

Section: Resultsmentioning

confidence: 99%

“…First described in 1905 in cadaveric specimens 8 and in 1975 in chest radiographs, 2 it is a highly specific sign, 2,9 which correlates well with functional severity 9 and is often the only sign on plain radiography for the diagnosis of chronic obstructive pulmonary disease (COPD). 1 By our personal anecdote, this very useful sign is currently greatly under-utilized in imaging reports.…”

Section: Introductionmentioning

confidence: 99%

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Sabre‐sheath trachea: An underused diagnostic weapon in the thoracic armoury

2021

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Introduction: A sabre-sheath trachea is a highly specific sign for chronic obstructive pulmonary disease. It also correlates well with the degree of disease. We hypothesized that the term is vastly under-utilized in radiologic reporting, despite its high diagnostic value. Methods: We interrogated our multisite metropolitan-wide radiology information system to find the number of CT reports containing the phrase 'sabre-sheath trachea' and conceivable variants thereof, over the 10 years to present. We compared this with the entire number of CT chest reports in the same time period in order to estimate the utilization of the sign. Results: The results confirmed our hypothesis that the sign is rarely invoked, likely around 1 in 41 times relative to opportunity. Conclusions: This highly specific sign of chronic obstructive small airway disease should be reinforced in training and utilized by radiologists.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sabre‐sheath trachea: An underused diagnostic weapon in the thoracic armoury

2021

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“…A deformed trachea is unlikely to collapse and it makes endotracheal intubation difficult. This malformation is more common in males and is usually associated with chronic obstructive pulmonary disease (COPD) [8].…”

Section: Sažetakmentioning

confidence: 99%

Saber-sheath trachea as a challenge for safe surgery: A case report

et al. 2019

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Introduction. Saber-sheath trachea is a rare malformation of the trachea marked with coronal narrowing with concomitant widening of sagittal diameter, with a sagittal-to-coronal diameter ratio exceeding 2:1. As tracheal rings are stiff and do not collapse around the tube, the intubation is difficult. Case Report. A 53-year-old female was referred to our hospital due to failed intubation at the local hospital during a planned surgery of skin melanoma. The patient was scheduled for surgery in our hospital, her case was presented to a panel of anesthesiologists and she was prepared for surgery. The intubation failed again, even though a video-assisted laryngoscope and endotracheal tube with 5 mm internal diameter was used. The anesthesiologist noticed that the endotracheal tube entered the trachea only 2 cm due to strong resistance, so further intubation was not an option in order to avoid damaging the trachea. The surgery was performed in local anesthesia with analgosedation. Later on, computed tomography was done, because of suspected pathological process compressing trachea, but the radiologist described the anomaly as saber-sheath trachea. One year later, the patient presented with axillary lymph node metastases and needed another surgery. This time the anesthesiologist knew about the trachea malformation, anticipated difficult intubation and used i-gel TM for airway management. Conclusion. Despite the fact that numerous methods have been developed for the purpose of identifying patients at risk of difficult intubation, there are many unexpected airway pathologies that can lead to failed intubation. Adequate preoperative assessment, knowledge of Guidelines for Difficult Intubation Management, availability of supraglottic airway devices, and cooperation between the surgeon and anesthesiologist, are crucial to successful patient management.

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“…3 The importance of diagnosing saber sheath trachea is that it is a fixed deformity of the trachea and remains same throughout the life and associated with Global initiative for chronic obstructive lung disease (GOLD) stages III and IV. 5…”

Section: Saber Sheath Trachea In Chronic Obstructive Pulmonary Diseasmentioning

confidence: 99%