Abstract
Homicidal cut throat is an injury over the front of neck by sharp instruments with an intent of murder. The neck contains vital structures (nerves, blood vessels, airway and pharyngeal conduit) in a compact fashion that may be difficult to access for physical examination or surgical exploration in a limited time. That is why these cases create panic and pose great challenges in the management. Here is a case of an attempted homicidal cut throat injury that highlights some of the challenges encountered in the management along with discussion on the evolving knowledge of the optimal management practice.
Highlights
Homicidal cut throat by definition are injuries over the front of neck by sharp instruments with an intent to kill.[1]
The neck contains vital structures including major blood vessels and airway in a compact fashion that may be difficult to access for physical examination or surgical exploration; posing a great challenge in the management.[2]
Picture 3: 10th postoperative day showing healthy skin wound Mucosal wound dehiscence was suspected in view of neck extension during suture removal and plan for starting oral feeding and removal of nutrition is best managed with Ryle’s tube (NG tube) was postponed for a week
Summary
Homicidal cut throat by definition are injuries over the front of neck by sharp instruments with an intent to kill.[1]. A 10 cm horizontal sharp wound extending across the hyoid injuring the anterior border of the sternocleidomastoid muscle bilaterally was present as shown in picture 1. Flexible nasopharyngolaryngoscopy (NPL) was performed on the 7th POD that showed arytenoid edema and redundant tissue at tongue base at the site of repair. Picture 2: 7th postoperative day showing arytenoid edema and redundant tissue at tongue base at the site of repair On 10th POD, skin wound was well healed as shown in picture 3; but when skin sutures were removed, patient developed throat pain and excessive oral secretion. Picture 3: 10th postoperative day showing healthy skin wound Mucosal wound dehiscence was suspected in view of neck extension during suture removal and plan for starting oral feeding and removal of NG tube was postponed for a week. Patient was discharged after 3 weeks of postoperative hospital course who recovered completely, as seen in the follow up evaluation at one month
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