feat: Add new articles on Allergic Bronchopulmonary Aspergillosis, Finger-in-Glove Sign, and Tracheal Dilatation; update content index and document conversion script

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title: "Tracheal Dilatation"
docid: "25c1fd77-52ff-4a56-b5c4-6ee1335ba369"
breadcrumbs:
- "Chest"
- "Differential Diagnosis"
- "Airways"
- "General Imaging Patterns"
- "Tracheal Dilatation"
---
# ESSENTIAL INFORMATION
- ## Key Differential Diagnosis Issues
- Tracheal wall composed of several layers: Mucosa, submucosa, cartilage or muscle, and adventitia
- Horseshoe-shaped bands of hyaline cartilage support anterior and lateral tracheal walls
- Posterior tracheal wall lacks cartilage and is supported by band of smooth muscle
- During expiration: Anterior bulging of posterior wall of intrathoracic trachea and ↓ of tracheal AP diameter by 32%
- Tracheal dilatation
- Women
- Tracheal transverse diameter > 21 mm, sagittal diameter > 23 mm
- Men
- Tracheal transverse diameter > 25 mm, sagittal diameter > 27 mm
- Tracheal index: Coronal diameter/sagittal diameter measured 1 cm above aortic arch
- Normal index ~ 1
- ## Helpful Clues for Common Diagnoses
- **Upper Lobe Fibrosis**
- Retraction of tracheobronchial walls
- Tuberculosis
- Sarcoidosis
- Hypersensitivity pneumonitis
- **Overdistention of Endotracheal Tube Cuff**
- Endotracheal tube or tracheostomy cannula cuff should not result in tracheal wall bulging
- Endotracheal cuff located 2 cm from distal end
- Overinflation of balloon to 1.5x diameter of normal trachea is associated with tracheal injury
- **Saber-Sheath Trachea**
- ↓ in coronal diameter of intrathoracic trachea associated with ↑ in sagittal diameter
- Associated with COPD (95%)
- Likely related to abnormal intrathoracic pressure
- **Tracheobronchomalacia**
- Condition characterized by excessive airway collapsibility caused by weakness of airway walls due to softening or destruction of supporting cartilage
- Tracheomalacia patients have dilated and flaccid airway
- ↓ in cross-sectional area > 70% during expiration compared with inspiration is generally considered diagnostic
- ## Helpful Clues for Less Common Diagnoses
- **Tracheal Diverticulum**
- Mucosal herniation through tracheal wall from ↑ intraluminal pressure
- Right posterolateral tracheal wall near thoracic inlet
- Between tracheal cartilaginous and muscular portions
- Communication with tracheal lumen rarely identified
- **Mounier-Kuhn Syndrome**
- Atrophy of muscular and elastic tissues in walls of trachea and mainstem bronchi
- More common in men
- Tracheal diameter > 30 mm (81.2%)
- Bronchiectasis (48.6-57.6%)
- Tracheal wall corrugated due to mucosa herniating between tracheal rings