Breakthrough Breast Cancer Research Unit, Western General Hospital, Edinburgh, UK.
Emerg Med J. 2011 Jul;28(7):629-31. doi: 10.1136/emj.02.2010.2735rep.
A 25-year-old man presented to the Emergency department in a rural South African hospital after a left, submental neck stab with a knife. Examination was deemed unremarkable, and the patient was discharged, but re-attended 2 days later complaining of a painful, swollen neck. Further examination identified Horner's syndrome, and further investigation revealed that the blade of the knife had remained in the patient's neck. This was successfully removed in theatre. This case illustrates the importance of careful history, examination and diagnostic imaging in the management of penetrating neck injuries. Horner's syndrome can be easily missed in a busy Emergency department and may indicate life-threatening pathology in the context of neck trauma. The difficulties in assessing and managing this type of injury are discussed.
一位 25 岁的男性在南非农村医院因左侧颏下颈部被刀刺伤后来到急诊部。检查结果无明显异常，患者被出院，但两天后因颈部疼痛肿胀再次就诊。进一步检查发现霍纳氏综合征，进一步调查发现刀的刀片仍留在患者的颈部。该刀片在手术室中成功取出。本病例说明了在处理穿透性颈部损伤时仔细询问病史、检查和进行诊断性影像学检查的重要性。在繁忙的急诊科中，霍纳氏综合征很容易被忽视，并且在颈部创伤的情况下可能表明存在危及生命的病理。讨论了评估和管理这种类型损伤的困难。
