Penetrating injury neck - An unusual presentation

Traumatic rupture of deep neck structures in hanging: two case reports

Injuries to the neck structures are various in case of hanging. Soft tissue lesions generally consist in sternocleidomastoid and subhyoid muscle hemorrhages. Traumatic ruptures of deep neck structures are rare. We report 2 cases of partial and complete ruptures of sternocleidomastoid muscles after suicidal hanging. Both were typical and complete hanging. In 1 case, muscle laceration was associated with common carotid rupture on the same side. Hemorrhage at the rupture site was only found at the microscopic level. Such injuries may result from the ligature's compression and depend on duration of suspension. Heavy body weight, rigid rope material, and fall after a jump may promote their occurrence.

Management of difficult airway in penetrating cervical spine injury

Management of airway in trauma victim with penetrating cervical/thoracic spine injury has always been a challenge to the anaesthesiologist. Stabilisation of spine during airway manipulation, to prevent any further neural damage, is of obvious concern to the anaesthesiologist. Most anaesthesiologists are not exposed to direct laryngoscopy and intubation in lateral position during their training period. Tracheal intubation in the lateral position may be unavoidable in some circumstances. Difficult airway in an uncooperative patient compounds the problem to secure airway in lateral position. We present a 46-year-old alcoholic, hypertensive, morbidly obese person who suffered a sharp instrument (screwdriver) spinal injury with anticipated difficult intubation; the case was managed successfully.