Throat firearm injury

Introduction

Brief introduction to throat firearm injuries Laryngeal firearm injuries are open laryngeal injuries, which can involve laryngeal cartilage and 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 rich surface of the blood vessels, the bleeding is often severe and prone to shock. If the carotid artery or jugular vein is severed and ruptured, it is too late to seek medical attention and immediately die. Dysphagia often causes swallowing movements due to sore throat. If you pass through the pharynx, the piriform fossa or the upper end of the esophagus, it is more difficult to swallow. Because the throat wound communicates with the outside of the neck, saliva and food can flow out of the wound. Mainly to stop bleeding, anti-shock and relieve breathing difficulties. After the operation, the infection should be controlled, and if necessary, the drainage should be placed. The narrow injury should be cut open and expanded to facilitate drainage. If the wound has signs of infection or suppuration, the suture should be removed in time, open, wet drainage, and avoid infection. Deep expansion and close observation. basic knowledge The proportion of illness: 0.004% Susceptible people: no specific population Mode of infection: non-infectious Complications: aspiration pneumonia osteomyelitis

Cause

Throat firearm injury

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 firearm injury prevention

Avoid trauma, control infection, place drainage if necessary, narrow wounds should be opened and expanded to facilitate drainage, if the wound has signs of infection and suppuration, the suture should be removed in time, open, wet drainage, to avoid infection Deep expansion and close observation.

Complication

Throat firearm injury Complications, aspiration pneumonia, osteomyelitis

Difficulty breathing can occur. In the case of firearm injuries, common complications include secondary bleeding, aspiration pneumonia, firearm osteomyelitis, restricted mouth opening, dislocation healing, and pseudoarticular formation. In the maxillofacial firearm injury, secondary bleeding is more common. Can be divided into mechanical bleeding and infectious bleeding. Mechanical hemorrhage occurs mostly in the first few days after injury, and is caused by blood clots or foreign bodies that temporarily cover the rupture of blood vessels.

Symptom

Laryngeal firearm symptoms common symptoms dyspnea dysphagia hoarseness subcutaneous emphysema arterial bleeding venous bleeding

Bleeding

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 rich surface of the blood vessels, the bleeding is often severe and prone to shock. If the carotid artery or jugular vein is severed and ruptured, it is too late to seek medical attention and immediately die.

Subcutaneous emphysema

Because of coughing, the intrathoracic pressure increases, the air enters the soft tissue of the neck from the rupture of the laryngeal mucosa, and the subcutaneous emphysema occurs in the neck, or the air penetrates from the neck and the throat through the wound into the subcutaneous tissue space, which can be extended to the face, chest and abdomen. .

Difficulty breathing

Due to cartilage fracture, mucosal bleeding, swelling caused. It can also cause blood retention due to blood flow into the lower respiratory tract, trachea, and bronchi, or emphysema. The above three symptoms are critical.

Sonar

In the glottic area, the trauma of the subglottic area, due to the injury of the vocal cords or recurrent laryngeal nerves, often have hoarseness and even loss of sound.

hard to swallow

Often because of sore throat, the swallowing action is hindered. If you pass through the pharynx, the piriform fossa or the upper end of the esophagus, it is more difficult to swallow. Because the throat wound communicates with the outside of the neck, saliva and food can flow out of the wound.

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, the skin wounds are small, multiple, often accompanied by severe emphysema. Cannonball wounds, mostly untidy wounds, often left behind in soft tissue.

Examine

Laryngeal firearm inspection

Direct observation.

1. Submucosal hematoma, hemorrhage, and even muscle necrosis appearing away from the injured. The range of bleeding along the direction of the muscle fibers can be very large. If the fascia that envelops the muscles is not fully cut, the chance of developing fascial syndrome will increase.

2. Although the projectile does not touch the bone, an indirect fracture may occur, which is characterized by a transverse or small bevel fracture.

3. Damage to tissues and organs outside the wound.

Diagnosis

Diagnosis of throat firearm injury

diagnosis

It can be diagnosed based on clinical symptoms and laboratory data.

Differential diagnosis

Distinguish from laryngeal trauma.

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