What to know after being punched in the throat

Getting punched in the throat may affect many internal structures, including the windpipe, spinal cord, and blood vessels. Diagnosis and treatment may vary depending on symptoms and the extent of the injury.

A punch to the throat may cause bruising and tenderness. It may also damage vital structures within the neck, which can be life threatening without treatment.

Doctors may refer to a punch in the throat as blunt trauma. Blunt trauma is a forceful impact to the body that does not pierce the skin or cause an open wound.

This article looks at what may happen to the neck area after a person receives a punch to the throat, when to seek medical help, and the treatment options.

What happens after blunt trauma to the throat?

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The symptoms a person experiences after a punch to the throat may depend on the parts of their throat that receive damage. Blunt trauma to the throat may affect the following areas:

  • larynx, which is the voice box
  • windpipe
  • esophagus
  • spinal cord
  • blood vessels
  • nerves

Symptoms affecting these areas may not occur immediately after the blunt trauma.

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Penetrating injuries are more likely to be life threatening than blunt trauma to the throat. However, blunt trauma that damages blood vessels in the throat typically has worse outcomes than blood vessel damage from penetrating injuries.

To examine throat and neck injuries, doctors may divide the neck area into three zones:

  • Zone 1: The bottom section of the neck, which includes the windpipe, jugular veins, which deliver blood from the brain to the heart, the spinal cord, cranial nerves, and certain arteries.
  • Zone 2: The middle section of the neck, which includes the spinal cord, arteries, and the vagus nerve, which connects to the brain.
  • Zone 3: The top section of the throat and mouth, which includes the carotid arteries and important nerves and veins.

Injuries to the zone 1 area may have the highest risk of death due to the concentration of blood vessels in that area and how close it is to the chest, which contains vital organs.

Symptoms of throat injury

Symptoms of a throat injury can depend on the affected area but may include the following:

  • tenderness
  • discomfort
  • difficulty or pain when swallowing
  • hoarse voice
  • difficulty speaking
  • crepitus, which is a grating, popping, or grinding sound
  • bruising
  • difficulty breathing
  • noisy breathing due to a restricted airway
  • coughing
  • coughing up blood

How do doctors diagnose throat injuries?

A physical examination may not always be reliable enough to determine the extent of a throat injury, particularly to find out if there is internal damage.

For a more complete examination of the throat and neck area, doctors may carry out the following tests:

  • a neck and chest X-ray
  • an angiogram, which uses X-ray with a special dye to show any damage to blood vessels
  • a CT angiogram, which uses a CT scan with a specialized dye to show any damage to blood vessels
  • a duplex ultrasonography, which uses ultrasound to show blood flow through blood vessels
  • a laryngoscopy, in which a doctor will insert a thin, flexible tube with a light at one end into the throat to examine the larynx and surrounding structures
  • an esophagram, which is an X-ray of the esophagus

The results of initial testing may indicate whether further testing is necessary. Further examination may involve a doctor using an endoscopy to look inside the throat. This procedure involves a small tube that may go through the person’s mouth.

Treatment

Treating a throat injury may depend on the location and extent of the damage. However, keeping the airways clear is always a priority during treatment.

The traditional sequence of a trauma response or resuscitation is:

  • airways
  • breathing
  • circulation

Following this, according to a 2021 article, doctors may immobilize the cervical spine, such as with a collar to hold the neck in place. They will do this until they have ruled out any conditions affecting the spine following blunt trauma to the neck.

According to this article, blunt trauma to the neck is unlikely to cause significant bleeding. However, if there is damage to blood vessels, doctors may use anti-bleeding medication, such as tranexamic acid, to control any bleeding.

When to speak with a doctor

It is best to consult a doctor after trauma or significant injury to the throat. Even if initial symptoms are not severe, they may progress to more serious conditions.

People need to seek emergency medical attention if they have any of the following symptoms after a throat injury:

  • difficulty breathing
  • changes to voice or breathing
  • sore throat
  • difficulty or pain when swallowing
  • wheezing
  • spinal pain
  • weakness or numbness
  • difficulty walking or using limbs as usual
  • significant swelling or pain

Summary

Getting punched in the throat may damage internal structures, such as the voice box, the airway, or blood vessels. It is best to speak with a doctor after a punch to the throat, as symptoms may not appear immediately, and initial symptoms may progress.

People need to seek medical attention immediately if they have any severe symptoms, such as difficulty breathing, difficulty swallowing, or significant pain and swelling.

Doctors may use imaging scans and endoscopy to examine the throat area for any internal damage. Treatments may depend on the affected areas and the extent of the injury.

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