관통성 경부 손상에 관한 임상적 고찰

Clinical Analysis of Penetrating Neck Injury: Review of 42 Operated Cases

Background: Penetrating neck injuries are potentially dangerous and require emergency management because of the presence of vital structures in the neck. The risk of airway, vascular, neurological, and pharyngoesophageal injuries leads to many difficult diagnostic decisions. The purpose of this retrospective study is to evaluate our experience with management of penetrating neck injuries, and to assess treatment outcome. Material and Method: Forty-two consecutive patients were identified (26 patients from Korea university Ansan hospital, 16 patients from Guro hospital) as having penetrating neck injuries from 2003 to 2009. With review of medical records, variables were collected and evaluated including the location of injury, mechanism of injury, number of significant injuries, diagnostic modalities, duration of hospital stay and outcome. Results: The location of injury was zone I (lower neck) in 13 cases (31%), zone II (midportion of the neck) in 22 (52%), and zone III (upper neck) in 7 (17%). Injuries were caused by stab wounds in 23 patients, penetrating foreign bodies in 12. Among 35 patients who had deep injuries that violated the platysma, significant injuries, including major vascular (20), trachea (5) Pharyngoesophageal injuries (5) were identified in 24 patients. The mean hospital stay was 9.5 days. Conclusion: The penetrating trauma in the neck may show various degrees of severity. However, Cervical penetrating injury should not be underestimated in spite of the minimal width of the lesion.