Large-vessel injuries of the neck admitted to Chongqing Emergency Medical Centre, China and Port Moresby General Hospital, Papua New Guinea, 1996-2006

ABSTRACT

Stab wounds are the main cause of large-vessel injuries in the neck and they have a fairly good prognosis when the patient receives expeditious and appropriate management. The objective of this study is to present the experience of managing patients with large-vessel injuries in the neck. A retrospective study was carried out involving 22 cases with vessel injuries in the neck over the past 10 years. Stab wounds accounted for 77% of this series (17 of 22 patients). All 22 cases were treated operatively. The overall survival rate was 95%. One patient died on the operating table because of torrential haemorrhage into the chest. Complications included one thrombosis of the right subclavian artery, and five cases of haemothorax, all of which resolved. Successful salvage of patients with major vessel injuries in the neck depends on familiarity with the anatomy, accurate and timely clinical diagnosis and expedient surgical intervention. Patients with haemodynamic instability, rapidly expanding cervical haematomas or uncontrollable bleeding require immediate operative intervention, forgoing any diagnostic study. Stable patients may undergo radiological studies to detect occult injuries that may result in late morbidity such as false aneurysms and arteriovenous fistulae.