Penetrating neck injury

Case contributed by Dr Heather Pascoe

Presentation

Stab wound to neck and chest

Patient Data

Age: 30
Gender: Female
CT

Neck

Neck

  • There is gas in the retropharyngeal, prevertebral and perivisceral space extending inferiorly to base of neck and superior mediastinum anteriorly with scattered locules of gas at the right base of tongue and anterior strap muscles.
  • Possible right internal laryngocoele.
  • No evidence of surrounding hematoma or contrast extravasation to suggest vascular injury.
  • Contour irregularity of the supraglottic larynx with surrounding locules of gas.
  • Findings suspicious esophageal and tracheal injury.
Fluoroscopy

Gastrograffin swallow was performed the following day.

Gastrograffin is seen to pass posteriorly from the hypopharynx into the prevertebral space at a level just inferior to the hyoid bone. The prevertebral space is considerably distended by gas.

Case Discussion

Penetrating neck injuries are associated with a high risk of significant injury because of the high concentration of vital structures in this small area. 

Blunt trauma to the esophagus is rare as it is well protected in the mediastinum. Tracheobronchial injuries are rarely seen as most patients die before reaching hospital.

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Case information

rID: 32863
Published: 9th Feb 2018
Last edited: 16th Jul 2018
System: Head & Neck
Inclusion in quiz mode: Included

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