Abstract text (incl. references and figure legends)
Case history, clinical findings
A 57-year-old man, with a psychiatric history of depression and paranoid personality disorder, is brought to the emergency department following a self-inflicted trauma of the neck with a blade.
Investigation/Results
Upon arrival at the emergency room, the patient had a patent airway, had no dyspnea or respiratory difficulty, was hemodynamically normal and without signs of poor peripheral perfusion. He was conscious, cooperative and oriented, without other associated injuries.
Diagnosis
The patient was observed by a trauma team, which documented a sharp wound in the right anterolateral-basal portion of the cervical region, without active hemorrhage, but reaching the deep planes. The patient was stabilized and proposed for emergent wound exploration and closure.
Therapy and Progressions
In the operating room, a deep cutting wound was observed at the cervical level IV, with 20 cm of length, partial section of the omohyoid muscle and total section of the right sternocleidomastoid muscle. Hemostasis and approximation of the perimysium of the omohyoid muscle and of the proximal and distal ends of the sternocleidomastoid is performed. The patient had no complications in the perioperative period and was discharged on the fourth postoperative day.
Comments
Suicidal cut throat injuries regularly encountered by surgeons are limited to superficial wounds and hesitation cuts. We hereby present a case of suicidal cut injury in a psychiatric patient with sternocleidomastoid muscle transection. Cut throat injuries to neck are challenging in terms of being surgical emergencies, varied presentations and requirement of an efficient team work.
References
Naqvi Sayyed EH, Sadik A, Beg MH, et al. Successful management of suicidal cut throat injury with internal jugular, tracheal and esophageal transection: A case report. Trauma Case Reports. 2018 Feb;13:30-34. DOI: 10.1016/j.tcr.2017.11.005. PMID: 29644295; PMCID: PMC5887116.
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