Monday, April 06, 2009
Tales from the Trauma Service XIX.....
Gentleman working on a landscpe project. The worker above him falls and drops one of these on him:
And they strike him in the neck. He arrives alert and oriented, but every time he speaks or coughs air comes out of the wound on his neck. Off to the operating room...
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THE FOLLOWING IMAGES MAY BE OFFENSIVE....blah, blah,.....
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The yellow circle represents the entry wound. Given his stability and the size I did not anticipate the degree of injury. I asked my friendly neighborhood ENT to assist. The yellow line indicates the endotracheal tube. The green line is the inferior portion of the thyroid cartilage, the white line the cricoid cartilage. He had been given a cricothyroidotomy. A tracheostomy was placed and the defect was covered with a rotated strap muscle. Post-injury direct laryngoscopy:
The black line points to the strap muscle.
The white line again indicates the muscle, the black lines represent the medial borders of the vocal cords. No evidence of vascular injury on exploration. Bronchoscopy allows for evacuation of some blood and esophagoscopy shows no injury.
Gentleman working on a landscpe project. The worker above him falls and drops one of these on him:
And they strike him in the neck. He arrives alert and oriented, but every time he speaks or coughs air comes out of the wound on his neck. Off to the operating room...
]
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]
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]
[
]
[
]
[
]
[
THE FOLLOWING IMAGES MAY BE OFFENSIVE....blah, blah,.....
[
]
[
]
[
]
[
]
[
]
The yellow circle represents the entry wound. Given his stability and the size I did not anticipate the degree of injury. I asked my friendly neighborhood ENT to assist. The yellow line indicates the endotracheal tube. The green line is the inferior portion of the thyroid cartilage, the white line the cricoid cartilage. He had been given a cricothyroidotomy. A tracheostomy was placed and the defect was covered with a rotated strap muscle. Post-injury direct laryngoscopy:
The black line points to the strap muscle.
The white line again indicates the muscle, the black lines represent the medial borders of the vocal cords. No evidence of vascular injury on exploration. Bronchoscopy allows for evacuation of some blood and esophagoscopy shows no injury.
Labels: Tales from the Trauma Service
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