A reliable early symptom of bronchial or tracheal rupture.

A tracheal or bronchial rupture is a severe lesion which is frequently overlooked during the initial post-traumatic period. The best results in the treatment of such ruptures are obtained by the earliest possible restoration of the continuity of the air passages. Early reconstruction, however, depends on early diagnosis. The diagnosis is established with certainty by means of bronchoscopy. The symptom of `deep cervical emphysema' is presented as an aid in selecting, from the many accident victims with chest injuries, those who should be submitted to bronchoscopy for immediate identification of any rupture of the major air passages. This deep cervical emphysema is readily recognizable on an antero-posterior radiograph of the cervical region and upper mediastinum.