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| Year : 1980 | Volume
: 26
| Issue : 4 | Page : 257-8 |
Stab injury of neck. (a case report).
Godbole BG, Vira TM, Rao RV
How to cite this article:
Godbole B G, Vira T M, Rao R V. Stab injury of neck. (a case report). J Postgrad Med 1980;26:257 |
It recent years, management of penetrating wounds of the neck has become of major interest to all surgeons dealing with trauma because of increasing urban violence. Trauma to neck frequently results in multiple regional organ injury and in addition, poses serious threats to vital structures in the neck.[1] The case reported here belongs to zone III category of Saletta's classification.[2]
This case presentation has been done because it had some peculiar features.
1. Important structures in the neck region.
2. The size of penetrating object.
3. Presentation of patient wish weapon in position.
4. No major injury to any structures in the neck.
A 22 year old male patient was brought to the Casualty at the L.T.M.G. Hospital on 26-12-78 at 12.15 A.M. with the history of being stabbed in the neck region half an hour back. Patient was conscious and his blood-pressure was normal with a pulse rate of 120 per minute. There was profuse bleeding from the mouth and the wound No. 1. Patient was breathless and tachypnoic. The wounds were as follows-
1. I.W. 11/2" x 11/2"? Deep (L) Diagastric Triangle.
2. I.W. 1/2" x 1/2" below (R) mastoid.
3. I. W. 2" x 1" Muscle Deep (R) Supra clavicular region.
Through wound No. 1 [Fig. 1] proximal end of the knife was projecting out for about 3 mm. Through wound No. 2 [Fig. 2]. The distal end of the knife (about 1/2" in length) was projecting upwards and backwards, just below the right mastoid process. The knife in the pharynx was lying transversely below the posterior 1/3 of the tongue and was occluding 3/4 of the air way. Emergency tracheostomy was performed which relived the breathlessness and facilitated erdotracheal suction. With the anticipation of the major vessel being cut patient was taken immediately for exploration of the wound. Patient was explored under general anaesthesia.
Cutting edge of the knife was facing anteriorly on which the right internal jugular vein and the common carotid artery were angulated anteriorly. The bleeding was from cut edges of the pharyngeal wall and strap muscles. After confirming that there was no major injury, the knife was taken out from wound No. 2. [Fig. 3], [Fig. 4] and [Fig. 5] show the radiological appearance and the size of the knife. [Fig. 3], [Fig. 4] and [Fig. 5].
Pharyngotomy incisions were closed with 00 chromic catgut with continuous stitches. Rest of the incision was closed in layers. Patient made uneventful recovery and was discharged on the 12th day. Before discharge indirect laryngoscopy done was normal.
We thank the Dean, and the Professor and Head of the Department of Surgery, L.T.M.M. College and L.T.M.G. Hospital for publishing this case report.
| 1. | Lundy, L. J., Mandal, A. K., Lou (sister), M. A. and Alexander, J. L.: Experiences in selective operations in the management of penetrating wounds of the neck. Surg. Gynec. and Obstet., 147: 845-848, 1978.  |
| 2. | Saletta, J. D., Folk, F. A. and Freeark, R. J.: Trauma to the neck region. Surg. Clin. North Amer., 53: 73-86, 1973. |
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