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Case Reports
. 2020 Dec 11:31:100379.
doi: 10.1016/j.tcr.2020.100379. eCollection 2021 Feb.

A 'Final Destination injury': Penetrating trauma of the neck and a pneumomediastinum by a metal part shot from a lawnmower

Marcel L J Quax  1 , Daniel Eefting  1 , Jeroen C Jansen  2 , Joris J Blok  1
Affiliations
Case Reports

A 'Final Destination injury': Penetrating trauma of the neck and a pneumomediastinum by a metal part shot from a lawnmower

Marcel L J Quax et al. Trauma Case Rep. .

Erratum in

Abstract

Introduction: Outside of war regions, penetrating neck injury is rare. Penetrating neck injury due to a lawnmower has never been described, despite the annual 74.000 injuries caused by lawnmowers in the United States. In this report, the case of a 65-year old women, admitted after a penetrating neck injury due to a metal piece shot from a lawnmower, is described.

Report: A 65-year old women, with no relevant medical history, presented at the Emergency Department after she was hit in the neck by an iron projectile shot from a professional lawnmower. On site, the projectile, a metal part from the lawnmower blade, was removed by her husband. CT scan showed a pneumomediastinum, without signs of vascular injury. Surgical exploration was immediately performed in the operation room (OR). No vascular or esophageal injuries werefound, only lacerated neck muscles. Perioperatively, the ENT surgeon performed an endoscopy, which showed a small injury of the hypopharynx. Postoperatively, the patient was prophylactically treated with antibiotics for 7 days. Patient was discharged in good clinical condition after 7 days, without complications.

Conclusion: In this report we present a case with a sharp traumatic injury of the neck, caused by a metal projectile shot from a lawnmower. The laceration of the pharynx was explored in the OR by the ENT- and vascular surgeon. The pneumomediastinum was treated with prophylactic antibiotics. Currently the patient is doing fine without any complications of the injury. Traumatic injury of the neck requires direct direct surgical exploration, however, when patients present hemodynamically stable, a neck CTA will add to the diagnosis (e.g. a pneumomediastium).

Keywords: Neck injury; Neck trauma; Penetrating injury.

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Figures

Fig. 1
Fig. 1
The metal part that was shot by a lawnmower (left) and the laceration at primary survey in the emergency department (right).
Fig. 2
Fig. 2
Neck regions (figure from; Ucak M Shrapnel Injuries on Regions of Head and Neck in Syrian War. J Craniofac Surg. 2020 Mar 23.).
Fig. 3
Fig. 3
Endoscopy image with small injury of the left vallecula.
Fig. 4
Fig. 4
Perioperative fiber endoscopy images; edema of the pharynx.
See this image and copyright information in PMC

References

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