A patient with suspected traumatic injury to the tracheobronchial injury usually undergoes bronchoscopy. Bronchoscopy is reliable for both detecting and quantifying the extent of injury.


Patient history: blunt trauma or penetrating injury to the chest


Findings that may indicate tracheobronchial injury:

(1) pneumomediastinum and/or pneumopericardium

(2) refractory pneumothorax, typically on the right side

(3) persistent or large air leak around an inflated endotracheal tube cuff

(4) persistent atelectasis

(5) marked subcutaneous emphysema

(6) tip of the endotracheal tube outside of the tracheal lumen

(7) a spherical endotracheal tube cuff seen on an X-ray

(8) overdistention of the cuff with an abnormally shape seen on X-ray


Additional findings in patients with tracheobronchial injury:

(1) dyspnea

(2) hemoptysis

(3) sternal tenderness

(4) neck and upper chest hematoma

(5) cyanosis

(6) upper thoracic rib fractures


The presence of one or more findings may justify bronchoscopy.

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