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| Eugene Ng,Ian Campbell,Andrew Choong,Allan Kruger,Philip J. Walker.[J].Chin J Traumatol,2018,21(2):118-121. [doi] |
| Forty hours with a traumatic carotid transection: A diagnostic caveat and review of the contemporary management of penetrating neck trauma |
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| DOI： |
| KeyWord: Penetrating neck trauma
Management penetrating neck trauma
Investigation penetrating neck trauma
Assessment penetrating neck trauma |
| FundProject: |
| Author Name | Affiliation | | Eugene Ng | Department of Vascular Surgery, Royal Brisbane & Women's Hospital, Herston, QLD 4006, Brisbane, Australia | | Ian Campbell | Department of Vascular Surgery, Royal Brisbane & Women's Hospital, Herston, QLD 4007, Brisbane, Australia | | Andrew Choong | Department of Vascular Surgery, Royal Brisbane & Women's Hospital, Herston, QLD 4008, Brisbane, Australia | | Allan Kruger | Department of Vascular Surgery, Royal Brisbane & Women's Hospital, Herston, QLD 4009, Brisbane, Australia | | Philip J. Walker | Department of Vascular Surgery, Royal Brisbane & Women's Hospital, Herston, QLD 4010, Brisbane, Australia |
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| Abstract: |
| Although penetrating neck trauma (PNT) is uncommon, it is associated with the significant morbidity and mortality. The management of PNT has changed significantly over the past 50 years. A radiological assessment now is a vital part of the management with a traditional surgical exploration. A 22 years old male was assaulted by a screwdriver and sustained multiple penetrating neck injuries. A contrast CT scan revealed a focal pseudoaneurysm in the left common carotid artery bulb. There was no active bleeding or any other vascular injuries and the patient remained haemodynamically stable. In view of these findings,
he was initially managed conservatively without an open surgical exploration. However, the patient was noted to have an acute drop in his hemoglobin count overnight post injury and the catheter directed angiography showed active bleeding from the pseudoaneurysm. Surgical exploration 40 hours following the initial injury revealed a penetrating injury through both arterial walls of the left carotid bulb which was repaired with a great saphenous vein patch. A percutaneous drain was inserted in the carotid triangle and a course of intravenous antibiotics for five days was commenced. The patient recovered well
with no complications and remained asymptomatic at five months followup. |
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