Residual foreign body in the neck after trauma results in the delayed rupture of the common carotid and internal jugular vein: a case report

Yan Luo,Zhong Sheng Cao,Hui Yuan

doi:10.1186/1752-1947-7-13

Abstract

IntroductionTrauma and foreign body residue occurring in different settings are common in the neck. Some small injuries go unrecognized, and vascular injuries caused by the sharp penetrating trauma of a foreign body are very dangerous. Without early diagnosis and treatment, foreign body residue remains a major cause of mortality.Case presentationA six-cm piece of wooden chopstick was not initially detected in the neck of a 24-year-old Chinese man presenting with a slight bleeding wound after a brawl accident. Three days later, the patient had an expanding neck hematoma and shortness of breath. Computed tomography revealed a dense shadow in the soft tissue of the left side of the patient’s neck, and surgical exploration found that a residual broken chopstick had resulted in a delayed rupture of the common carotid artery and internal jugular vein.ConclusionA residual foreign body should be seriously considered after neck trauma because it can result in a lethal hemorrhage originating from a delayed rupture of blood vessels.

Highlights

A residual foreign body should be seriously considered after neck trauma because it can result in a lethal hemorrhage originating from a delayed rupture of blood vessels
Trauma and foreign body residue occurring in different settings are common in the neck
In conclusion, delayed rupture of the common carotid artery (CCA) is an uncommon yet potentially life-threatening condition, which can be caused by a residual foreign body following trauma

Summary

Introduction

Trauma and foreign body residue occurring in different settings are common in the neck. We report an unusual case in which a chopstick stabbed into the patient’s neck initially resulted in subcutaneous emphysema and slight bleeding, but three days later a rupture of the common carotid artery (CCA) and internal jugular vein (IJV) caused hemorrhage in the neck after a sudden bout of coughing. Anteroposterior and lateral X-rays of the patient’s neck revealed subcutaneous emphysema and no foreign body in the soft tissues (Figure 1). There was significant relief of the subcutaneous emphysema and wound swelling in the first two days He still felt pain and the movement of his neck was restricted. Tomography (CT) scan revealed extensive subcutaneous emphysema in the neck and upper breast region, and a dense linear shadow at the level of the 7th cervical vertebra and 1st dorsal vertebra whose ends were embedded in the pre-vertebral soft tissue and parapharyngeal space (Figure 2).

Discussion

Conclusion