Surgical Management of Penetrating Wounds of the Neck

Shirkey, Albert L.

doi:10.1001/archsurg.1963.01310120073012

Cited by 49 publications

(6 citation statements)

References 20 publications

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“…An alternative conservative approach recommends that surgery be undertaken only in the presence of diagnostic criteria suggestive of major injury (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28).…”

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confidence: 99%

Penetrating injuries of the neck: A prospective study of 108 patients

Campbell

Robbs

1980

Journal of British Surgery

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One hundred and eight patients were admitted to King Edward VIII Hospital, Durban, with a penetrating wound of the neck and were managed by a conservative policy. Intervention was undertaken if, and only if, there was an indication of damage to deep structures. Data were collected prospectively. Significant sequelae were seen in only 50 patients (46 per cent) and 26 underwent surgery. Three patients died from their neck injuries (2.8 per cent). 2 after operative intervention and 1 after conservative management. Morbidity was higher after surgery, though local sepsis in wound haematomas was more common in those treated conservatively. A selective policy for surgical intervention is safe and justifiable. A minimum mortality and morbidity can be obtained by adequate preoperative evaluation which includes the use of contrast radiography and angiography.

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confidence: 99%

Penetrating injuries of the neck: A prospective study of 108 patients

Campbell

Robbs

1980

Journal of British Surgery

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“…Time to treat, from initial presentation to definitive management seems to be one of the most important factors in influencing mortality ( 9 , 58 ). A delay in diagnosis of an esophageal injury can lead to mortality of up to 60% in some series ( 6 , 54 , 59 ). This is most likely due to an unrecognized sepsis that can occur due to spillage of enteric contents through an esophageal injury.…”

Section: Discussionmentioning

confidence: 99%

Non-iatrogenic esophageal trauma: a narrative review

Schraufnagel¹,

Mubashir²,

Raymond³

2022

Mediastinum

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Background and Objective Non-iatrogenic esophageal trauma is a rare entity that has a high morbidity and mortality. The diagnosis can often be quite challenging, however is critical to perform in a timely manner. The workup and management of non-iatrogenic trauma continues to evolve, with new innovative approaches available for both diagnosis and treatment. The aim of this narrative review is to comprehensively describe the incidence, presentation, workup, treatment approaches and outcomes of non-iatrogenic esophageal trauma. Methods A thorough literature review was performed using full length articles available in English via PubMed between January 1, 1960 to September 30, 2021, focusing on the epidemiology, workup and treatment of non-iatrogenic esophageal trauma, including current surgical techniques. Key Content and Findings Injuries to the cervical esophagus are more common than injuries to the thoracic esophagus, occurring more in young males, with significant racial disparity. Penetrating trauma via gunshot wounds are the most common forms of injury, followed by stab wounds and blunt trauma. Workup is multimodal and involves a combination of plain radiographs, computed tomography (CT) scans, endoscopy and fluoroscopy depending of the stability of the patient and associated injuries. Conclusions Workup and management of non-iatrogenic esophageal trauma depends on the location and extent of esophageal injury, and can include observation, debridement and drainage, esophageal diversion, endoscopic approaches or esophagectomy, with indications, techniques and outcomes described in further detail in this review.

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“…In extensive reviews of this subject by Fogelman and Stewart (1956), Stone and Callahan (1963), and Shirkey, Beall, and De Bakey (1963), only one case of trauma to the ascending cervical artery is described. They advise that the management of this type of injury should be based on immediate resuscitation followed by assessment and an early decision to either explore or observe.…”

Section: Discussionmentioning

confidence: 99%

“…They advise that the management of this type of injury should be based on immediate resuscitation followed by assessment and an early decision to either explore or observe. Shirkey et al (1963) report that the mortality is trebled if exploration is not carried out before six hours. These considerations underline the urgent need to demonstrate the nature of the increasing pleural shadow, which in our patient was later coupled with the signs of hypovolaemia.…”

Section: Discussionmentioning

confidence: 99%