The nonoperative management of penetrating internal jugular vein injury. J Vasc Surg 2006 Jan;43(1):77-80
Date
01/18/2006Pubmed ID
16414392DOI
10.1016/j.jvs.2005.09.012Scopus ID
2-s2.0-30544450977 (requires institutional sign-in at Scopus site) 21 CitationsAbstract
OBJECTIVE: The objective of this study was to review the outcome of nonoperative treatment for penetrating internal jugular vein (IJ) injuries in a continuous series of prospectively identified, hemodynamically stable patients.
METHODS: All penetrating neck injuries assessed from February 1, 2004, to August 31, 2004, were prospectively identified. Patients without an indication for urgent neck exploration underwent diagnostic assessment with multislice helical computed tomographic angiography with or without vascular ultrasonography. All IJ injuries with no other indication for surgical exploration were treated nonoperatively. All patients were discharged home and followed up for a minimum of 1 week to document outcomes.
RESULTS: From 51 neck injuries penetrating the platysma, 7 required urgent neck exploration, during which 2 IJ injuries were ligated. Forty-four patients underwent multislice helical computed tomographic angiography. Eight IJ injuries (two gunshot wounds and six stab wounds) with no other indication for neck exploration were identified and managed nonoperatively. One external wound was in zone 1, five were in zone 2, one was in zone 3, and one traversed all three zones. The average length of stay was 4.5 days. At follow-up, ranging from 1 week to 5 months, all patients were asymptomatic, and no patient required delayed operation for IJ injury.
CONCLUSIONS: In hemodynamically stable patients with no other indication for exploration, the nonoperative management of penetrating jugular vein injuries should be considered as a safe alternative.
Author List
Inaba K, Munera F, McKenney MG, Rivas L, Marecos E, de Moya M, O'Keeffe T, Pizano L, Cohn SAuthor
Marc Anthony De Moya MD Chief, Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Female
Humans
Jugular Veins
Male
Prospective Studies
Wounds, Penetrating
