Penetrating neck injury caused by a foreign body: a case report

A 30 year old man is admitted to the emergency section with the complaint of bleeding from the neck after an industrial explosion. A laceration, 5 cm's in length, is seen on 'zone II', near the medial border of the anterior jugular triangle. The patient was hemodynamically stable, but there was active bleeding from the laceration. A round mass is detected with palpation adjacent to the bifurcation of carotis. The wound is explored under anesthesia with endotracheal intubation. Major vessels and other vital structures found to be undamaged. Many authors suggest mandatory exploration for the neck wounds that penetrated the platysma, while others prefer exploration for selected cases on the basis of diagnostic studies. Immediate exploration is indicated in the presence of active bleeding, and diagnostic studies should be reserved for haemodynamically stable patients. Injury of major vessels might be tamponaded by foreign bodies, therefore blind removal of the objects may cause life-threatening hemorrhage. Endotracheal intubation is appropriate in the management of airway, as for convenient surgical approach.