Quax Marcel L J, Eefting Daniel, Jansen Jeroen C, Blok Joris J
Departments of Vascular Surgery, Leiden University Medical Center, Leiden, the Netherlands.
Departments of Otorhinolaryngology, Leiden University Medical Center, Leiden, the Netherlands.
Trauma Case Rep. 2020 Dec 11;31:100379. doi: 10.1016/j.tcr.2020.100379. eCollection 2021 Feb.
Outside of war regions, penetrating neck injury is rare. Penetrating neck injury due to a lawnmower has never been described, despite the annual 74.000 injuries caused by lawnmowers in the United States. In this report, the case of a 65-year old women, admitted after a penetrating neck injury due to a metal piece shot from a lawnmower, is described.
A 65-year old women, with no relevant medical history, presented at the Emergency Department after she was hit in the neck by an iron projectile shot from a professional lawnmower. On site, the projectile, a metal part from the lawnmower blade, was removed by her husband. CT scan showed a pneumomediastinum, without signs of vascular injury. Surgical exploration was immediately performed in the operation room (OR). No vascular or esophageal injuries werefound, only lacerated neck muscles. Perioperatively, the ENT surgeon performed an endoscopy, which showed a small injury of the hypopharynx. Postoperatively, the patient was prophylactically treated with antibiotics for 7 days. Patient was discharged in good clinical condition after 7 days, without complications.
In this report we present a case with a sharp traumatic injury of the neck, caused by a metal projectile shot from a lawnmower. The laceration of the pharynx was explored in the OR by the ENT- and vascular surgeon. The pneumomediastinum was treated with prophylactic antibiotics. Currently the patient is doing fine without any complications of the injury. Traumatic injury of the neck requires direct direct surgical exploration, however, when patients present hemodynamically stable, a neck CTA will add to the diagnosis (e.g. a pneumomediastium).
在战区以外，穿透性颈部损伤较为罕见。尽管在美国每年有74000起因割草机导致的损伤，但从未有过因割草机造成穿透性颈部损伤的描述。在本报告中，描述了一名65岁女性因割草机射出的金属碎片导致穿透性颈部损伤后入院的病例。
一名65岁女性，无相关病史，在被专业割草机射出的铁制抛射物击中颈部后被送往急诊科。在现场，她的丈夫取出了抛射物，即割草机刀片上的一个金属部件。CT扫描显示有纵隔积气，无血管损伤迹象。随即在手术室进行了手术探查。未发现血管或食管损伤，仅颈部肌肉有裂伤。围手术期，耳鼻喉科医生进行了内镜检查，发现下咽有一处小损伤。术后，患者接受了7天的抗生素预防性治疗。7天后患者临床状况良好出院，无并发症。
在本报告中，我们呈现了一例由割草机射出的金属抛射物导致的颈部锐器伤病例。耳鼻喉科医生和血管外科医生在手术室对咽部裂伤进行了探查。纵隔积气采用预防性抗生素治疗。目前患者情况良好，无任何损伤并发症。颈部创伤需要直接进行手术探查，然而，当患者血流动力学稳定时，颈部CT血管造影（CTA）有助于诊断（如纵隔积气）。
