Retained knife blades in the ear, nose and throat: three cases

Lierop, A C van; Raynham, Oliver; Basson, O.; Lubbe, Darlene

doi:10.1017/s0022215108002089

Cited by 9 publications

(8 citation statements)

References 5 publications

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“…Studies have shown patients who present at emergency departments across the globe with such pattern of retained craniofacial foreign objects tend to have a high level of alcohol consumption [1] , [15] though contrary to what was found in our case report where no history of alcohol consumption was reported but rather assaulted by thieves while selling items at his shop.…”

Section: Discussioncontrasting

confidence: 98%

“…In cases of excessive arterial bleeding, angiography can help to identify a bleeding vessel that can then be managed by selective embolization or surgical ligation. If the path of the knife is clear of the skull base and major vessels, angiography is not mandatory as was found in this reported case, thus not necessitating angiography [1] , [6] , [8] , [10] , [15] .…”

Section: Discussionmentioning

confidence: 99%

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Jael's syndrome: Case report and literature review

Abraham

Lomnyack

Kimario

et al. 2021

International Journal of Surgery Case Reports

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Introduction and importance Jael's syndrome, an intentional injury caused by a knife in the face or skull is a rare encounter in clinical and forensic practice, rarely involving an impacted knife. Clinical and radiographic diagnosis is essential to identify severity of injury and location of the retained knife. To the best of our knowledge, this is the first reported novel case of Jael's syndrome in Tanzania. Case presentation We present the case of a 31-year old man admitted at Muhimbili National Hospital following an impacted knife. The stab wound extended to the medial wall of left orbit and ended just before the optic foramen associated with vitreous hemorrhage and the retained knife caused superoposterior displacement of the globe. Multidisciplinary management was instituted including prompt evaluation, imaging and surgical removal of the knife under general anesthesia. Clinical discussion Plain skull X-ray revealed an extensive retained blade and computerized tomography (CT) showed the tip of the blade adjacent to the right styloid process with no neurovascular compromise. Initial concern was the left eye that was reported to be viable by ophthalmologists. Incredibly, the patient had no initial sequelae from such an extensive injury and had unremarkable recovery with no complications apart from the wound to left inferior rectus muscle that was conservatively managed. Simple withdrawal of the retained knife was successful. Conclusion Craniofacial retained knives are rare. Thorough prompt initial evaluation and intervention is vital since improper management can be devastating.

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Section: Discussioncontrasting

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Jael's syndrome: Case report and literature review

Abraham

Lomnyack

Kimario

et al. 2021

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 99%

“…Imaging with CT scans are vital in assessment of the injury to determine the path of the wound, and to identify vascular injury [1,3,4,7]. There have been several reports where there was successful removal of the foreign body via the entrance wound [1,2,7]. This was only performed after careful dissection and identification of important structures, and after confirming the absence of significant vascular injury [2,4,5].…”

Section: Discussionmentioning

confidence: 99%

Penetrating Eye Injury

Chiew¹,

Choy²

2012

Journal of Case Reports in Medicine

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A 38-year-old man presented to a regional Western Australian hospital after being stabbed in his left eye with a knife. Computerized Tomography (CT) revealed a 7 cm knife blade within the globe extending along the skull base. After transfer to a tertiary hospital, a cerebral angiogram was performed, excluding significant cerebral vascular involvement. Through a multidisciplinary approach with the otolaryngology and ophthalmology teams, the knife was removed without incident. The patient made a good post operative recovery and visual acuity continued to improve on follow-up appointments.

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“…4,5 While there are well-established guidelines on the management of PNI, the literature on the management of a retained knife in the neck is mostly anecdotal as very few centers have accumulated sufficient experience to formulate evidence-based management algorithms for this specific scenario. [6][7][8][9][10][11] Certain management principles are generally agreed upon by most authors. Uncontrolled extraction outside the operating room (OR) is strongly discouraged.…”

Section: Introductionmentioning

confidence: 99%

The Management of Penetrating Neck Injury With Retained Knife: 15-Year Experience From a Major Trauma Center in South Africa

Kong

Cheung

et al. 2021

The American Surgeon

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Background This study reviews our cumulative experience with the management of patients presenting with a retained knife following a penetrating neck injury (PNI). Methods A retrospective cohort study was conducted at a major trauma center in South Africa over a 15-year period from July 2006 to December 2020. All patients who presented with a retained knife in the neck following a stab wound (SW) were included. Results Twenty-two cases were included: 20 males (91%), mean age: 29 years. 77% (17/22) were retained knives and 23% (5/22) were retained blades. Eighteen (82%) were in the anterior neck, and the remaining 4 cases were in the posterior neck. Plain radiography was performed in 95% (21/22) of cases, and computed tomography (CT) was performed in 91% (20/22). Ninety-five percent (21/22) had the knife or blade extracted in the operating room (OR). Formal neck exploration (FNE) was undertaken in 45% (10/22) of cases, and the remaining 55% (12/22) underwent simple extraction (SE) only. Formal neck exploration was more commonly performed for anterior neck retained knives than the posterior neck, although not statistically significant [56% (10/18) vs 0% (0/18), P = .096]. There were no significant differences in the need for intensive care admission, length of hospital stay, morbidities, or mortalities between anterior and posterior neck retained knives. Discussion Uncontrolled extraction of a retained knife in the neck outside of the operating room may be dangerous. Retained knives in the anterior neck commonly required formal neck exploration but not for posterior neck retained knives.

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Retained knife blades in the ear, nose and throat: three cases

Cited by 9 publications

References 5 publications

Jael's syndrome: Case report and literature review

Jael's syndrome: Case report and literature review

Penetrating Eye Injury

The Management of Penetrating Neck Injury With Retained Knife: 15-Year Experience From a Major Trauma Center in South Africa

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