throat stab wound
Introduction
Brief introduction to throat injury Throat stab wounds are open throat injuries, which can affect the laryngeal cartilage and the fascia of the larynx. Such as through the throat, it is called penetrating laryngeal trauma. Most of the bleeding comes from the laryngeal artery, the sublingual branch of the facial artery, the thyroid artery or the thyroid tissue. Because of the abundant blood vessels, the bleeding is often serious and prone to shock. If the carotid artery and jugular vein are severed and ruptured, they will die as soon as they seek medical treatment. Difficulty breathing is caused by cartilage fracture, mucosal bleeding, and swelling. It may also cause blood retention due to blood flowing into the lower respiratory tract, trachea, and bronchus, or emphysema and pneumothorax may cause difficulty in breathing. The above three symptoms are critical. First aid measures are mainly to stop bleeding, resist shock and relieve breathing difficulties. The disease is mainly caused by external, should pay attention to avoid trauma. basic knowledge The proportion of illness: 0.1-0.5% Susceptible people: no specific population Mode of infection: non-infectious Complications: throat stenosis
Cause
Cause of laryngeal stab wound
1. Firearm injuries include guns, guns, shrapnel and bayonets. Bullets are generally penetrating wounds and the range is limited. The shrapnel can break the entire throat and have a wide range of damage.
2. Inadvertently hit the debris during the blasting of the industrial and mining, or the explosives in the workshop.
3. In a traffic accident, the throat is injured by glass or iron.
4, sharp injuries in the bucket, or intentionally committed suicide with a knife.
Prevention
Throat stab wound prevention
The disease is mainly caused by external, should pay attention to avoid trauma.
Complication
Throat stab wound complications Complications
Infection leads to cartilage necrosis, or due to improper treatment of early wounds, sequelae, larynx, trachea, esophageal scar stenosis, fistula formation or vocal folds and other sequelae.
Symptom
Symptoms of laryngeal stab wounds Common symptoms Dyspnea, traumatic bleeding, hoarseness, subcutaneous emphysema, cough, hoarseness, difficulty swallowing
1, bleeding: bleeding from the laryngeal artery, sublingual branch of the facial artery, thyroid artery or thyroid tissue, because the blood vessels are rich, bleeding is often more serious, prone to shock. If the carotid artery and jugular vein are severed and ruptured, they will die as soon as they seek medical treatment.
2, subcutaneous emphysema: more than due to cough, the intrathoracic pressure increased, the air from the throat mucosal rupture into the neck soft tissue and the neck subcutaneous emphysema, or air from the neck skin and throat through the wound into the subcutaneous tissue gap, Expanded to the face, chest and abdomen.
3, breathing difficulties due to cartilage fractures, mucosal bleeding, swelling caused. It may also cause blood retention due to blood flowing into the lower respiratory tract, trachea, and bronchus, or emphysema and pneumothorax may cause difficulty in breathing. The above three symptoms are critical.
4, sonar: trauma in the glottis area, subglottic area, due to damage to the vocal cords or recurrent laryngeal nerves, often have hoarseness and even loss of sound.
5, difficulty swallowing: often due to sore throat, swallowing action is hindered. If the pharynx, piriform fossa or upper esophagus is worn through, and saliva leaks out, swallowing is more difficult. Because the throat wound communicates with the outside of the neck, saliva and food can flow out of the wound.
6. Wound condition: The shape of the wound is related to the injury device. When the knife is cut, the skin has a large wound and the edges are neat, often a single incision. Scissors, daggers and other sharp sharps of the stab wound, skin wounds are small, multiple, often accompanied by severe emphysema. Cannonball wounds, mostly untidy wounds, often left behind in soft tissue.
Examine
Laryngeal stab wound examination
Flat film performance
In the acute phase, laryngeal soft tissue edema deformation and laryngeal stenosis can be seen. Calcified laryngeal cartilage fractures can show that the fracture line and misplaced neck emphysema are distributed along the neck muscle space, showing strips of gas. In the late stage, the structure of the laryngeal cavity is asymmetrical, deformed or partially disappeared, and functional activities are limited. If accompanied by granulation, a soft tissue mass with a different range and a narrow airway can be seen.
2.CT performance
In the early stage of injury, hemorrhage and edema are characterized by diffuse thickening of the mucosa, increased density of the anterior and posterior epiglottis, stenosis of the larynx, and dislocation of the laryngeal cartilage. Separation of the bone fragments, accumulation of soft tissue around the throat, often honeycomb Or strip air shadow. After the healing of the deformity, CT can determine the thickening and adhesion of the various structures and the extent of involvement.
3. MRI performance
According to the signal changes, hematoma, mucosal edema and soft tissue damage can be distinguished. The three-dimensional image RJ clearly distinguishes the cartilage fracture and its displacement direction.
Diagnosis
Diagnosis and identification of laryngeal stab wound
The diagnosis of open throat injury is not difficult. Closed laryngeal injury is easily misdiagnosed because there is no wound on the skin of the neck. Therefore, there is a history of trauma to the neck, blood in the sputum after the injury, hoarseness, subcutaneous emphysema in the neck should be further examined, and a neck X-ray photograph of the laryngotracheal tube can be diagnosed.
Clinical diagnosis should also provide a detailed understanding of the nature, location, extent, and cartilage fractures of the injury, which is important for determining the treatment policy. Generally, according to the local examination, the X-ray photograph can be clearly defined, but if necessary, the fiber can be used for fiber bronchoscopy or CT scanning to help determine the extent of the injury.
Severe throat tracheal trauma often combined with craniocerebral, maxillofacial, chest, cervical and other combined injuries. Special care should be taken during diagnosis to prevent omissions from endangering life.
