Water Spout Injection Into the Neck

An unusual high-pressure injection injury involving the cervical spinal cord

“…We were only able to identify two reported cases, both caused by clean water and neither leading to a neurological deficit. 3,4 In our case, the lesions were underestimated because of the small puncture wound, the paucity of initial symptoms, and inadequate initial debridement.…”

Non-operative management of water injection injury to the neck

“…The high pressures of many commercial washers are capable of injecting significant amounts of water and air deep into tissue—resulting in dissection of underlying fascial planes and damage to neurovascular structures [6–9]. The extent of injury is poorly reflected on the surface with subcutaneous emphysema and edema being common findings [4,5,9]. In our case, the patient displayed a relatively small punctuate wound.…”

“…The case described in this report details the non-operative management of a high-pressure water injection injury to Zone III of the neck. Once considered a surgical emergency, such injuries are increasingly being managed non-operatively [4,5]. Several factors must be considered in the selection of patients for conservative management.…”

Hydraulic fracturing-induced delamination and extravasation extends medial damage beyond the false lumen in aortic dissection

“…Examples include detachment of cell membrane from the underlying cytoskeleton during blebbing (32,33), breaks in nuclear envelopes during cell migration through confining environments (34,35), and disruption of adhesive contacts separating cells (36,37). While hydraulic fracturing is not specifically invoked in pathogenesis, high-pressure injection injuries from industrial tools in the workplace can result in digit amputations (38,39) and numerous case reports describe soft tissue injuries in children from high-pressure washer devices (40)(41)(42), even water/air infiltration from a standard pressure bath faucet in the context of penetrating trauma (43). Conversely, hydraulic fracturing has therapeutic applications for separating tissues with less trauma than cutting instruments by a technique of hydrodissection using directed jets of fluid (44).…”