Timely management of penetrating neck trauma: Report of three cases
A 20-year-old male was admitted to our emergency room in respiratory distress. He had been stabbed in the neck in a fight. A laceration in the submental area had been sutured at another hospital. After being followed for 1 hour in the first hospital, he was discharged. Subsequently, he developed swelling in the submental region and then progressively worsening respiratory distress. Indirect laryngoscopy showed a mass in the vallecula, and his vocal cords could not be seen clearly. There was an approximately 7-cm-long horizontal skin incision in the submental area. Neck ultrasonography showed a hematoma in the submental region. Under orotracheal general anesthesia, we opened the sutures and extended the incision by 1 cm at both ends. We drained the hematoma and saw that a branch of the lingual artery had been cut. We ligated the bleeding vessel and followed the incision to the right vallecula. On direct laryngoscopy, we saw a small laceration on the right anterior vallecula surface and no other pathology. We used a Hemovac tube for drainage. Then, we sutured the cut muscles, platysma, and cutaneous tissue on both sides. He was extubated without any problem and did not need a tracheotomy.