![]() ![]() The patient may exhibit dysphonia or have diminished breath sounds, and rapid breathing is common. ![]() However, isolated TBI does not usually cause profuse bleeding if such bleeding is observed it is likely to be due to another injury such as a ruptured large blood vessel. Dyspnea and respiratory distress are found in 76–100% of people with TBI, and coughing up blood has been found in up to 25%. Many of the signs and symptoms are also present in injuries with similar injury mechanisms such as pneumothorax. There are no direct signs of TBI, but certain signs suggest the injury and raise a clinician's suspicion that it has occurred. Signs and symptoms vary depending on what part of the tracheobronchial tree is injured and how severely it is damaged. Signs and symptoms Pneumothoraces of both lungs (large arrows), pneumomediastinum (small arrow) and subcutaneous emphysema in a patient with complete disruption of the right bronchus. In severe cases, surgery may be necessary to repair a TBI. In the emergency setting, tracheal intubation can be used to ensure that the airway remains open. Signs and symptoms vary based on the location and severity of the injury they commonly include dyspnea (difficulty breathing), dysphonia (a condition where the voice can be hoarse, weak, or excessively breathy), coughing, and abnormal breath sounds. Diagnosis involves procedures such as bronchoscopy, radiography, and x-ray computed tomography to visualize the tracheobronchial tree. Early diagnosis is important to prevent complications, which include stenosis (narrowing) of the airway, respiratory tract infection, and damage to the lung tissue. TBI is frequently difficult to diagnose and treat. Of those who do reach a hospital, the mortality rate may be as high as 30%. Of those people with TBI who die, most do so before receiving emergency care, either from airway obstruction, exsanguination, or from injuries to other vital organs. Other injuries accompany TBI in about half of cases. Though rare, TBI is a serious condition it may cause obstruction of the airway with resulting life-threatening respiratory insufficiency. It can result from blunt or penetrating trauma to the neck or chest, inhalation of harmful fumes or smoke, or aspiration of liquids or objects. ![]() Tracheobronchial injury is damage to the tracheobronchial tree (the airway structure involving the trachea and bronchi). Reconstruction of the trachea and bronchi with x-ray computed tomography showing disruption of the right main bronchus with abnormal lucency (arrow) Medical condition Tracheobronchial injury ![]()
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