Penetration of the neck by an unusual foreign body

Abstract

Background: Wounds are among the commonest presentation to the emergency department. A true appreciation of the mechanism of injury i.e. the transfer of energy and likely anatomy involved in any source of injury is vital for further management.1Salanke U. Kidner N. Peneteration of the iliac wing by retained foreign body.Emerg Med J. 2009; 26: 302Crossref PubMed Scopus (1) Google Scholar Case Report: We present the extraordinary case of a 24-year-old intoxicated male with a delayed presentation of a penetrating neck injury. The patient claimed that he fell down a flight of stairs the previous evening and a foreign body had penetrated his neck. He then went to sleep and woke up the following morning with a sore throat! There were no witnesses to confirm his story. Preoperative imaging revealed a large 11 cm foreign body of uncertain density, passing anterior and posterior to the left and right carotid sheaths respectively with no exit wound noted. Exploratory surgery revealed a ‘remarkable’ object that corroborated the patient's somewhat questionable history in his intoxicated state. The patient was discharged from intensive therapy unit three days following admission. Discussion: Issues of note include the importance of objective history taking, understanding various mechanisms of injury, preoperative and intraoperative imaging, the interesting antibiotics advice in such a unique case, and the necessity of a tracheostomy in non-mucosal breach.