Forty hours with a traumatic carotid transection： A diagnostic caveat and review of the contemporary management of penetrating neck trauma

作     者：Eugene Ng Ian Campbell Andrew Choong Allan Kruger Philip J. Walker Ng Eugene;Campbell Ian;Choong Andrew;Kruger Allan;Walker Philip J

作者机构：Department of Vascular Surgery Royal Brisbane & Women's Hospital Herston QLD 4006 Brisbane Australia 

出 版 物：《Chinese Journal of Traumatology》 (中华创伤杂志（英文版）)

年 卷 期：2018年第21卷第2期

页      面：118-121页

核心收录：

学科分类：0821[工学-纺织科学与工程] 080704[工学-流体机械及工程] 08[工学] 0807[工学-动力工程及工程热物理] 082103[工学-纺织化学与染整工程] 

基　　金：supported by the Beijing Natural Science Foundation(7152061) Beijing Council of Science and Technology(Z161100000116080) 

主　　题：Penetrating neck trauma Management penetrating neck trauma Investigation penetrating neck trauma Assessment penetrating neck trauma 

摘      要：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 tri- angle 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.