Lodhia Jay, Chugulu Samwel, Wampembe Elizabeth, Chilonga Kondo, Msuya David
Department of General Surgery, Kilimanjaro Christian Medical Centre, P O Box 3010, Moshi, Tanzania; Kilimanjaro Christian Medical University College, Faculty of Medicine, P O Box 2240, Moshi, Tanzania.
Department of General Surgery, Kilimanjaro Christian Medical Centre, P O Box 3010, Moshi, Tanzania; Kilimanjaro Christian Medical University College, Faculty of Medicine, P O Box 2240, Moshi, Tanzania.
Int J Surg Case Rep. 2023 Oct;111:108891. doi: 10.1016/j.ijscr.2023.108891. Epub 2023 Oct 1.
Penetrating neck injuries (PNIs) are common and are associated with arterial injuries in 10-25 % of the cases, with carotid artery twice as frequent as to vertebral arteries. Carotid artery injury constitutes about 22 % of all cervical vascular injuries.
We present a case of a 44-year-old male who sustained penetrating neck injury in a motor traffic crash. He presented with monoplegia of his right upper limb and an open wound on the left side of his neck which was not actively bleeding hence surgical debridement was done and sutured. CT angiography and CT-scan brain concluded of left common carotid thrombosis secondary to penetrating neck trauma with ischemic brain injury. Patient was successfully managed conservatively.
The general mortality rate in PNI with associated cervical vascular injury is approximately 66 %. Artery dissection occurs when the intima tears causing intramural hematoma leading to narrowing or occlusion. CT angiography is the best and fastest modality to assess these injuries and management depends on the clinical bases of the patient.
Neck is vulnerable to external trauma because it is not protected by the skeleton. The neck contains vital structures such as the trachea, esophagus, blood vessels and nervous system organs. Vascular injuries can be life-threatening owing to its prompt clinical assessment and investigation.
穿透性颈部损伤（PNIs）很常见，在10%至25%的病例中与动脉损伤相关，其中颈动脉损伤的发生率是椎动脉的两倍。颈动脉损伤约占所有颈部血管损伤的22%。
我们报告一例44岁男性，在机动车交通事故中遭受穿透性颈部损伤。他表现为右上肢单瘫，颈部左侧有一处开放性伤口，无活动性出血，因此进行了手术清创和缝合。CT血管造影和脑部CT扫描结果显示，因穿透性颈部创伤继发左侧颈总动脉血栓形成，并伴有缺血性脑损伤。患者经保守治疗成功康复。
伴有颈部血管损伤的穿透性颈部损伤的总体死亡率约为66%。当内膜撕裂导致壁内血肿，进而引起血管狭窄或闭塞时，就会发生动脉夹层。CT血管造影是评估这些损伤的最佳且最快的方式，治疗方案取决于患者的临床情况。
颈部容易受到外部创伤，因为它没有骨骼的保护。颈部包含气管、食管、血管和神经系统器官等重要结构。由于需要及时进行临床评估和检查，血管损伤可能会危及生命。
