Hundersmarck Dennis, van Koperen Paul J, Leenen Loek P H, de Borst Gert J, Houwert R Marijn, Hietbrink Falco
Universitair Medisch Centrum Utrecht, afd. Heelkunde, Utrecht.
Contact: D. Hundersmarck (
Ned Tijdschr Geneeskd. 2019 Aug 9;163:D2879.
Penetrating neck injuries (PNIs) as a result of stabbing or deliberate self-harm are complex and potentially life-threatening. Nowadays, selective non-operative management of PNI has become common practice. Diagnostic and treatment algorithms originating from high-volume trauma centres in South-Africa and North-America are used in Dutch clinical practice. Three patients that sustained a PNI are discussed. Two patients, aged 61 and 37, only had mild signs on physical examination that justified additional diagnostic investigations. In the first patient, a penetrating oesophageal injury was found and repaired. The latter had a partial Horner syndrome as a result of PNI, no underlying injuries were found. One patient, aged 57, was haemodynamically unstable and therefore received immediate surgical exploration of the neck. A penetrating injury of the jugular vein was discovered and repaired. A summary of literature and guidelines is presented for the benefit of Dutch physicians that may be confronted with these complex injuries.
因刺伤或蓄意自残导致的颈部穿透伤(PNIs)情况复杂,且可能危及生命。如今,对颈部穿透伤进行选择性非手术治疗已成为常见做法。源自南非和北美的大容量创伤中心的诊断和治疗算法被应用于荷兰的临床实践中。本文讨论了3例颈部穿透伤患者。两名患者,年龄分别为61岁和37岁,体格检查仅有轻微体征,有必要进行进一步的诊断性检查。首例患者被发现有穿透性食管损伤并进行了修复。后者因颈部穿透伤出现了部分霍纳综合征,未发现潜在损伤。一名57岁的患者血流动力学不稳定,因此立即接受了颈部手术探查。发现并修复了颈静脉穿透伤。为可能面临这些复杂损伤的荷兰医生提供了文献和指南总结。