Evaluation and management of penetrating wounds of the neck: the role of emergency angiography.

With the use of emergency angiography, careful observation, and monitoring, 40 consecutive patients with penetrating wounds were selectively managed. Eleven patients were operated on with one negative exploration and one death. Twenty-nine patients were observed after negative angiography without operation on the neck and were subsequently discharged without' overlooking a significant vascular or visceral injury or amy complication. We believe this policy to be safe and effective. It should reduce the number, the morbidity, and the cost of needless mandatory surgical explorations and should guard against clinically undetected serious injuries. Operations should be reserved for those patients with clinically obvious servere vascular or visceral injury and for those with radiographically demonstrated significant lesions.