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Forty hours with a traumatic carotid transection: A diagnostic caveat and review of the contemporary management of penetrating neck trauma / 中华创伤杂志(英文版)
Chinese Journal of Traumatology ; (6): 118-121, 2018.
Article in English | WPRIM | ID: wpr-691031
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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Full text: Available Index: WPRIM (Western Pacific) Main subject: General Surgery / Wounds, Penetrating / Diagnostic Imaging / Carotid Artery, Common / Neck Injuries / Carotid Artery Injuries / Computed Tomography Angiography Type of study: Diagnostic study Limits: Humans / Male Language: English Journal: Chinese Journal of Traumatology Year: 2018 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: General Surgery / Wounds, Penetrating / Diagnostic Imaging / Carotid Artery, Common / Neck Injuries / Carotid Artery Injuries / Computed Tomography Angiography Type of study: Diagnostic study Limits: Humans / Male Language: English Journal: Chinese Journal of Traumatology Year: 2018 Type: Article