Autor(es): Alves, Duarte Gil ; Sousa, Jessica ; Ferreira, Vítor ; Almeida Pinto, João ; Teixeira, Nuno
Data: 2023
Identificador Persistente: http://hdl.handle.net/10400.16/2918
Origem: Repositório Científico da Unidade Local de Saúde de Santo António (ULSSA)
Assunto(s): acute care surgery and trauma; carotid artery surgery; ct (computed tomography) imaging; knife injury; neck trauma; penetrating trauma neck; steel blade; penetrating stab wound
While rare in incidence, penetrating neck injuries are often life-threatening. When a patient's physiological status is appropriate, the first step in treatment should be a detailed preoperative imaging assessment. Formulating a treatment plan that includes computed tomography (CT) imaging and discussing the surgical approach with a multidisciplinary team before operating allows for a successful selective surgical approach. The authors report the case of a Zone II penetrating injury with a right laterocervical entry wound in which an impaled blade with an inferomedial oblique path pierced deeply into the cervical spine. The blade missed multiple vital structures in the neck, such as the common carotid artery, jugular vein, trachea, and esophagus. The patient underwent a formal neck exploration, and controlled extraction of the blade under direct vision was achieved. Therefore, the author's recommendation for implementing any management algorithm for penetrating neck injuries should rely primarily on a multidisciplinary selective approach.
