Stab Wound

September 14, 2005
Achal Dhupa, MD

A 32-year-old man was brought to the emergency department after being stabbed in the right side of the neck with a broken piece of glass. The patient immediately underwent carotid angiography; the findings were normal.

A 32-year-old man was brought to the emergency department after being stabbed in the right side of the neck with a broken piece of glass. The patient immediately underwent carotid angiography; the findings were normal.

Results of an indirect laryngoscopic evaluation and an esophageal examination ruled out injury to the larynx and the esophagus. A roentgenogram of the neck revealed the presence of air in the deep fascial tissue planes of the neck. The patient was otherwise hemodynamically stable.

Air in the neck tissue is a cause of concern, since it may lead to pneumomediastinum. Generally, air in fascial planes of the neck is caused by trauma; the condition also may occur secondary to neck surgery, dental extraction, or deep space infection. The underlying cause needs to be identified and treated.

This patient was observed in the intensive care unit. Within a few days, the air in the neck tissue planes resorbed, and the patient recovered.

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