Reconstructive

541) A 20 year old patient has a penetrating injury, stab wound to the right side of his neck. (See drawing below.) The patient arrived at the ER, stable, alert and oriented. He has a huge hematoma in the lower aspect of his neck. The peripheral pulse in his right arm is weak. Which of the following is the MOST APPROPRIATE management for this particular patient?

A. Zone I neck injury, immediate neck exploration
B. Zone I neck injury, angiography prior to neck exploration
C. Zone III neck injury, immediate neck exploration
D. Zone III neck injury, angiography prior to neck exploration
E. Zone I neck injury, immediate midline sternotomy




REFERENCES & ANSWER



Stewart M. G.: Penetrating Face and Neck Trauma, Chapter 68 Head and Neck Surgery – Otolaryngology, (Bailey), Lippincott Williams & Wilkins, Third Edition, pp. 817-820, 2001

Stewart M. G.: Penetrating Face and Neck Trauma, Chapter 72 Head and Neck Surgery – Otolaryngology, (Bailey), Lippincott Williams & Wilkins, 4th Edition, pp. 1017-1026, 2006


541) B          Zone I neck injury, angiography prior to neck exploration