Cervical impalement injury to a child by a chopstick diagnosed with computed tomography and ultrasonography

Abstract

Injuries penetrating into the floor of the mouth in the oral cavity caused by chopsticks are rare. We report a case of neck impalement injury caused by a wooden chopstick fragment penetrating all the way through the base of the tongue. An 18-month-old boy fell off his chair when he was biting on a wooden chopstick. Four centimeters of the chopstick broke off but could not be found, so he was brought to our emergency department with minor bleeding from the tongue. Computed tomography (CT) revealed that the fragment had penetrated through the tongue into the neck. Ultrasonography (US) revealed that the fragment was in close proximity to the common carotid artery. Surgery for the removal of the chopstick tip was uneventful, with minimal soft tissue trauma. Postoperative progress was satisfactory and without complications. Of particular interest is the sensitivity of US in outlining the broken chopstick fragment lodged in the neck. It is noteworthy that the contrast of the chopstick greatly varied between CT and US.