INTERNATIONAL JOURNAL OF MEDICAL AND APPLIED SCIENCES ISSN:2320‐3137 308 www.earthjournals.org Volume 2 Issue 3 2013 CASE REPORT MANAGEMENT OF PENETRATING INJURIES OF NECK The Past, the present and the future Kumar S V 1 ,Rajkamal V 2 ,Chakravarthy D S 3 ,Kirankuamr G 4 ,Anurag J 5 1 Professor , Department of Surgery, Andhra Medical College, Visakhapatnam Andhra Pradesh India. 2 Associate professor , Department of Surgery, Andhra Medical College, Visakhapatnam Andhra Pradesh India. 3 ,4 Assistant Professors , Department of Surgery, Andhra Medical College, Visakhapatnam Andhra Pradesh India. 5 Post graduate , Department of Surgery, Andhra Medical College, Visakhapatnam Andhra Pradesh India ABSTRACT Penetrating injuries though rare are a significant source of morbidity and mortality 1 . These injuries constitutes 5-10% of all trauma cases attending casualty department 2 . Diagnosting imaging plays an integral role in the management of the penetrating neck injuries 3 . Treatment protocols have shifted from non-operative modality to expectant surgery. KEY WORDS: Arterial Injury , Laryngotracheal injury ,Penetrating neck injury INTRODUCTION Neck wounds that penetrates the platysma are regarded as penetrating injuries of neck. The injuries in this region have a special significance because of high concentration of vital anatomical structures in a narrow space and potential for life threatening events. CASE REPORT A 24 yr old male patient sustained an injury in a road traffic accident in which a wooden foreign body got embedded in the neck. The foreign body pierced the neck structures as evident by CT angiogram from left to right of : skin, subcutaneous tissue, Sterno Cleido Mastoid(SCM) left, hypophaynx, SCM(R) and passing between Internal Carotid Artery and External Carotid Arteries just above the bifurcation of the carotid artery . After delicate surgery lasting for nearly 2 hrs, the wooden foreign body measuring 15x6 cm was extracted from the neck, avoiding injury to great vessels, trachea, esophagus and other vital structures. The patient made an uneventful recovery. When a patient with a penetrating neck injury presented to the casualty, a rapid assessment of airway, breathing and circulation is carried out. Despite the urgency of a vascular injury, the maintenance of airway is the number one priority.