Vascular injuries of the neck a prospective study of 36 patients

ABSTRACT

To evaluate the proper role of clinical examination alone in the diagnosis of vascular injury of the neck in a less equipped hospital. Design: Thirty six patients with vascular injuries to the neck, admitted during 1982-96 were prospectively studied. Setting: Diseases Department of Cardiovascular Surgery, the National Institute Cardiovascular [NICVD], Dhaka, Bangladesh. Patients Thirty six patients admitted with vascular injury to the neck were studied. Main outcome measures: Incidence of vascular injury to the neck, patients undergoing neck exploration on the basis of clinical evaluation alone. Stab wounds constituted more than 66% of vascular injuries in the neck. Out of total 36 patients 16 had carotid artery and 20 had external or internal jugular vein injuries. Lateral suture repair of 20 vessels and end to end anastomosis of 12 vessels were performed without perioperative neurologic deficit. Four cases of common carotid artery [CCA] pseudoaneurysms undergone aneurysmectomy and end to end anastomosis or vein patch repair while on one patient with A-V fistula between CCA and internal jugular vein, ligation and excision of the fistula and Dacron patch repair of the arterial wall defect was performed. Conclusions; The correct decision of neck exploration for suspected vascular injuries can be taken on clinical findings alone while advanced diagnostic facilities are either lacking or absent. Based on our findings routine use of angiagrophy in penetrating neck injuries is probably not justified