Suppuration in the adult Lincoln’s highway-surgeon’s dilemma

Abstract

The carotid sheath enclosing the common carotid artery, internal jugular vein, vagus and the deep jugular lymph nodes continues around the vessels of the superior mediastinum. This sheath formed by the investing fascia, prevertebral fascia and the pre-tracheal fascia is captioned the Lincoln s highway. Suppurative pathology of the Lincoln highway presents as a vertical swelling at the anterior border of the sternomastoid. USG, CT and MRI confirms the diagnosis and prompts surgical intervention and thus prevents intra thoracic spread with its morbidity and mortality.