Neck trauma (injury)

Description The neck contains m...

Description

The neck contains many important and vulnerable structures. Trauma can be blunt from a motor vehicle accident or fall, or be penetrating from a gunshot wound or stabbing. The following injuries can occur: tracheal (causing airway obstruction); esophageal (leading to mediastinitis); carotid artery or vena cava (causing exsanguinations or stroke); cervical spine (sometimes resulting in fracture and/or paralysis).

Symptoms

Depends on which structures are damaged. Tracheal injuries: problems breathing, air in the soft tissue of the neck, airway blockage. Esophageal injuries: difficulty swallowing, chest pain, air in the soft tissues of the neck. Carotid or vena cava injuries: expanding mass in neck, profuse bleeding from neck, weakness, focal neurological deficits, coma. Cervical spine injuries: neck pain, weakness, inability to move the arms and/or the legs, difficulty breathing, numbness.

Tests

Common tests used for diagnosis and treatment

Workup:
A history and physical exam will be performed. Additional tests may be done dependent on the mechanism and extent of suspected injury.

Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), CT Scan, Electrocardiogram (EKG), Magnetic resonance imaging (MRI), Troponin, X-ray

Other Specific Tests: Endoscopy, Esophagram, Bronchoscopy, Arteriogram

Specialists:
Neurosurgery, Trauma Surgery, Pediatric Neurosurgery

Treatment

Neck is stabilized to prevent movement until the extent of injury is determined. Treatment depends on the injured structures. Immediate surgery may be needed. Intubation to establish an airway will be performed if airway damage is suspected.