Penetrating Neck

Injuries

Dr Georgina Harris

High mortality

The difference…..

KE = ½ mv2

Anatomy

Zones – prognosis and managment

ZONE I

ZONE I

ZONE II

ZONE I

ZONE II

ZONE III

Is the patient stable?

Theatre

YES

Zone I Zone II

NO

Zone III

Imaging

asymptomatic

Imaging

Interventional radiologyor surgery

Concern on examination

Observe/Image

TheatreInterventional

radiology

Is the patient stable?

Theatre

YES

Zone I Zone II

NO

Zone III

Imaging

asymptomatic

Imaging

Interventional radiologyor surgery

Concern on examination

Observe/Image

TheatreInterventional

radiology

Is the patient stable?

Theatre

YES

Zone I Zone II

NO

Zone III

Imaging

asymptomatic

Imaging

Interventional radiologyor surgery

Concern on examination

Observe/Image

TheatreInterventional

radiology

Questions?

Key points

• Exan• Leading cause of immediate death is exsanguination

• Esophageal injuries represents the most frequently missed injury and may be leading cause of delayed death

• Compound difficulties in evaluation & Mx is the complicated anatomy - dense concentration of vital structures in a small space

• Ongoing debate : mandatory vs selective exploration