Homicidal cut throat injuries by definition are injuries over the front of neck by sharp instruments using a long blade with a murderous intent. Cut throat injury presenting as emergencies in a tertiary. Regarding presentation, the no of patients attended at emergency with open wound and bleeding were 24 40%, cut throat injury with respiratory distress were 14 cases 23. Management of the upper airway in severe cut throat injuries. This requires the close collaboration of the otolaryngologist, the anesthetist and the psychiatrist. An unusual case of penetrating tracheal cut throat injury due to chain snatching. The ceo, in his thousanddollar suit, jumped up and sat on the floor with the secretary for the next ten minutes, picking up and recollating the papers.
Management of homicidal cut throat injury at a peripheral. All five cases of vehicular accident 33% suffered blunt trauma. The approach to airway management in pni varies widely according to clinical presentation and local practice, such that global management statements are lacking. Primary tracheal reconstruction in cut throat injury of a 4 years old child. The cause of injury is homicidal, suicidal and rta in nature. These injuries could be accidental, homicidal or suicidal and the use of a sharp weapon is the least frequent suicidal method in most cases reported. Case report open access management of suicidal cut throat.
The management of these injuries requires a multidisciplinary approach. Cut throat injuries causes profound morbidity due to prolonged hospitalization, high cost of health care, loss of productivity and reduced quality of life and above all death 1, 2. Cut throat injuries are potentially life threatening due to the peculiarity of the structures traversing this region of the body. Management of homicidal cut throat injuries requires a multidisciplinary approach. We report the survival of an extremely rare case of complete laryngo pharyngeal transaction following incision trauma with knife. Cutthroat injuries ctis are defined as incised injuries or those resembling incised injuries in the neck inflicted by sharp objects. Successful management of suicidal cut throat injury with internal jugular, tracheal and esophageal transection. A study on behavior and management of suicidal cut throat. Cut throat injury is a potentially life threatening emergency often encountered by ear, nose, and throat surgeons. In one, the injury was just above the larynx, the offending object being a piece of glass pane.
Cut throat injury accounts for about 5 to 10 percent of all traumas. The injury is a deep puncture wound or the person has not had a recent within the last 5 to 10 years tetanus shot or booster the cut is from a human or animal bite 4. The incidence of suicidal cut throat injuries in our country may be fortunately rare or the cases are unreported in literature. As there are a very few scientific papers published in the management of cut throat injuries in this part of the state, this paper is an attempt to highlight the issue. All the cut throat injuries examined, irrespective of the injury directly or indirectly contributing to the death were studied. Cut throat injuries are challenging in terms of management as it necessitates close collaboration by otolaryngologists, anaesthetists, psychiatrists, speech therapists and general surgeons. Aims and objectives 1 to study the socio demographic pattern of cut throat injuries at our hospital.
The seriousness of the injury depends on the angle of thrust of the cutting object, the location of the injury, and the amount of tissue damage. If there is evidence of bleeding into the airway, the patient should. Prevention of these complications depends on immediate resuscitation by securing the airway by tracheostomy or intubation, prompt control of hemorrhage and blood replacement. Successful management of suicidal cut throat injury with internal. Primary tracheal reconstruction in cut throat injury of a 4. The cut throat injury may involve soft tissue, cartilage, bones or neurovascular bundles. Such injuries are rarely reported in the literature. Cut throat injuries are uncommon mode of committing suicides in indian subcontinent. Rao bk, singh vk, ray s, mehra m 2004 airway management in trauma. Suicidal cut throat injury and successful repair tracheostomy scars as well as the cut throat scar were healing well, he was in good spirits and taking regular diet. The horizontal wound measured about 12x4 cm, and was over the infrahyoid area above the true vocal cords. Pdf introduction cutthroat injuries ctis are defined as incised injuries or those resembling incised injuries in the neck inflicted by sharp. In boxing and the martial arts, throat trauma is a fairly common sight, occurring in one out of 200 fights.
Pdf introduction cut throat injuries ctis are defined as incised injuries or those resembling incised injuries in the neck inflicted by sharp. These injuries are usually superficial with multiple hesitation marks. The role of an anesthesiologist in instituting an airway using an endotracheal intubation or tracheostomy before wound exploration and repair of transected tissues, is challenging, as, such injuries are most of the time associated with distortion of the normal anatomy of the airway. Suicidal cut throat injuries are either unreported or fortunately rare in our country.
Jul 12, 2017 wood jw, thornton b, brown cs, mclevy jd, thompson jw. Here, we present a case of homicidal cut throat injury to the airway leading to aspiration and hypoxia. The management of these injuries requires a multidisciplinary approach requiring the close association of the otolaryngologists, the vascular surgeons, the anesthetists and the psychiatrists 4. Cut throat article about cut throat by the free dictionary. Management of suicidal cut throat injuries in a developing nation.
Homicidal cutthroat injuries are incised injuries or those simulating incised injuries in the neck inflicted by sharp objects. Ramesh p, raj lt, ramesh b, suman t, bishow t 2015 management of cut throat injury. Almost all the patients presented at emergency and needed urgent surgical intervention. Role of anesthesiologist in managing a rare case of. A retrospective study of 30 cases of cut throat injury presenting as emergency were managed over a two year period from june 2010 to june 2012. Herzog m, hoppe f, baier g, dieler r 2005 injuries of the head and neck in suicidal intention. The objective of the present study is to analyze the clinical presentation of cut throat injuries, to propose a management protocol in the treatment. Treatment of cut throat injury patients given at our hospital and outcome. Cut throat injuries are one of the emergency conditions managed by ent specialists. Journal of universal college of medical sciences 3.
Introduction cutthroat injuries ctis are defined as incised injuries or those resembling incised injuries in the neck inflicted by sharp objects. Clint malarchuk was the cowboy goalie, infamous for one of the most gruesome injuries in the history of sports. A childs propensity to place objects in their mouth, along with their unsteady gait, make trauma to the palate more common in these patients. Anesthetic management of a case of suicidal cut throat injury. Statistical data analysis was done using spss software version 17. The aim of the study was to study on cut throat of injuries including its incidence factors provoked and management. Management of a suicidal cut throat injury is fraught with complications and requires a multidisciplinary approach. A rare case of survival after homicidal laryngo pharyngeal. Suman arasikere panchappa, rajaganesh kuttuvu swamirao, dhinakaran natarajan subject. Serious injuries are those to the tonsil, soft palate, or back of the throat. The purpose of these reports is to emphasize that suicidal cut throat injuries do occur in our environment and there is a need for the collaboration of the otorhinolaryngologist, anesthesiologist and psychiatrist in the effective management of these patients. Mild degree of subglottic stenosis could he dilated to yield good airway thus avoiding major surgery.
Cut throat injuriesa retrospective study at a tertiary referral hospital. Recognizing and managing traumatic neck injuries jems. Management of homicidal cutthroat injuries requires a multidisciplinary approach. Cicala rs, kudsk ka, butts a, nguyen h, fabian tc 1991 initial. Injury management is a coordinated and managed process consisting of activities and procedures to facilitate a timely, safe, and durable return to work for injured workers. Management of severe cut throat injury in zaria, nigeria bakari a. Cut throat injuries with suicide as the motivating factor usually require rapid and interdisciplinary treatment. Injuries to the palate are relatively common in the pediatric population. Role of anesthesiologist in managing a rare case of homicidal. It includes treatment of the injury, rehabilitation back to work, and management of the compensation claim. Oct 31, 2015 management of a suicidal cut throat injury is fraught with complications and requires a multidisciplinary approach.
Cut throat injuries international journal of contemporary medical. The injury had occurred an hour ago he came to the emergency room. Cutthroat, details his remarkable 30 for 30 shorts. A study of incidence, causes and management of cut throat injuries. The causes of throat injuries are usually due to gunshot or a knife wound either accidental, suicidal or homicidal. Neck being relatively unprotected anatomic region is a common site for injuries that are potentially dangerous and require immediate management. This paper presents our experiences with managing three unemployed adult nigerian males two of hausa ethnicity and one from the tiv ethnic group presenting with cut throat injuries following suicidal attempts. Case report was possible to pass a small uncuffed tube through the wound into the trachea. Cut throat injuriesa retrospective study at a tertiary. Management of atypical suicidal cut throat injury in a. African journal of medicine and medical sciences 2001. Adoga senior lecturerconsultant ear, nose, throat, head and neck surgeon department of ear, nose, throat head and neck surgery university of jos and jos university teaching hospital nigeria 1. Cut throat injuries a retrospective study at a tertiary referral hospital.
Cutthroat injury is a unique form of trauma that is potentially devastating and associated with significant airway problems as well as substantial emotional, physical and financial burden on the community and hospital resources1. Cut throat zone ii neck injury and advantage of a feeding jejunostomy. Management of cutthroat injuries beigh z, ahmad r egypt j. The aim of the present study is to evaluate the pattern of injury, its management and associated psychiatric illness in suicidal cti. Cut throat injuries is trauma that needs prolonged hospitalization, high cost of health care and reduced quality of life and above all death. Jan 14, 2014 this was a combined retrospective and prospective study of cut throat injury patients who were managed at bugando medical centre between february 2009 and january 20. Cut throat injuries in children are rare, but they constitute a significant management challenge. Penetrating neck trauma in operation iraqi freedom. Successful management of suicidal cut throat injury with. Venkatachalam sg, palaniswamy selvaraj da, rangarajan m, mani k, palanivelu c. The present study was conducted to study the sociodemographic profile of.
Case report a 27yearold male patient came to the emergency room with the homicidal cut throat. Four cases of cutthroat injury were suicidal and two patients sustained injury following assault. Definite incidence of homicidal cutthroat injuries is unavailable as many are fatal before making it to a. Early and proper management in expert hands can prevent mortality and morbidity. Cut throat definition of cut throat by medical dictionary. The commonest cause of laryngeal trauma was cutthroat injury seen in six patients 40%. Evaluation and treatment of such injuries is a tough task. The clinical record underlines the importance of prompt airway. Homicidal cutthroat injuries are potentially life threatening because of the many vital structures that course through this area.
Injuries to the throat comprises one of the major methods adopted to kill or as a mean to severe the head, so as to conceal the victims identity or as a mode of revenge. Puncture wounds here can cause a deep space infection in the neck. Cut throat injuries are one of the emergency conditions managed by e. Management of injuries that penetrate the platysma depends upon the anatomic level of injury. The important structures damaged involvement of air and food passages. Technicality of managing cut throat injury open access. A study of incidence, causes and management of cut throat. Cut throat injuries are a unique form of trauma that is potentially devastating and associated with substantial emotional, physical and financial burden on community and hospital resources. There is first aid treatment for a throat injury and definitive treatment at an emergency room or hospital. Anaesthetic management in cut throat injuries a report of.
In a case of cut throat injury, there may be possibility of injury to the vital structures that may become rapidly fatal from profuse haemorrhage by damaged major blood vessels, air embolism or airway obstruction. Injury to the palate general information iowa head and. Complications during the management are analyzed and treated. The advantages of fibreoptic endoscopes have not been mentioned in the management of the patient with a cut throat injury, although they have been recommended for difficult intubation taylor and towey, 1972. Management of atypical suicidal cut throat injury in a private tertiary hospital adeyeye rachael adetola 1, akinola moses ayodele 1, fasesan oluwatoyin 2, ogundare emmanuel 3, agbaakin adewale daniel 1 1otorhinolaryngology unit, department of surgery, babcock university teaching hospital, ilishan. When they occur, a multi disciplinary approach is required in the effective management of affected patients. We hereby report a case of cut throat injury with complete transection of trachea and its management. Although rapid sequence intubation rsi may be safe in most patients with pni, the highrisk subset 10% of patients with laryngotracheal injury require particularly judicious airway. A total of 30 cases of cut throat injuries were included. Primary tracheal reconstruction in cut throat injury of a. We present to you a rare case of suicidal cut throat injury in a 38 year old male with depressive type of. In cases of attempted suicide, hesitant marks are a common finding. Management of homicidal cut throat open airway injury. Management of homicidal cut throat injury at a peripheral set up.
We hereby present a case of suicidal cut throat injury in a psychiatric patient with right internal jugular, tracheal and esophageal transection. Suicide is one of the 10 leading causes of death in the world and cut throat injuries cti are fairly common due to suicide. Introduction suicide is defined as the act of taking one s life. Airway management of an open penetrating neck injury. Homicidal cutthroat injuries by definition are injuries over the front of neck by sharp instruments using a long blade with a murderous intent. Cut throat injuries are increasing rapidly in this region. Brennan j, lopez m, gibbons md, hayes d, faulkner j, dorlac wc, et al.
It requires a close collaboration between the anesthetist, the otorhinolaryngologist and the psychiatrist. Technicality of managing cut throat injury open access library. They are clinically interesting and pose a challenge to the surgeon in the management. Two cases of cut throat injury are presented because of the marked similarity in their presentation and management. Although a cut throat injury is mainly a mortal situation, the outcome is directly related with the speed of intervention and the properties of the injury. Contact 911 as these situations can go bad quite quickly. The management of cut throat injuries is bedeviled with complications which can be reduced to the barest minimum if managed well by the specialists.
Cut throat injuries at a university teaching hospital in. These do not need sutures unless the outer cut is gaping. Six out of the ten cut throat injuries treated at casualty department are homicidal in nature. Primary tracheal reconstruction in cut throat injury of a 4 years old child author. Management of suicidal cut throat injuries in a developing. This was suggestive of repeated unsuccessful attempts ending up with fatal cut throat injury. An autopsy study of 74 cases of cut throat injuries. A total of 98 patients with cut throat injuries were studied.
1330 178 1223 1289 962 1395 788 1233 866 355 635 1586 97 540 293 675 1388 1019 584 1511 932 1356 1457 989 185 514 318 769 1622 83 776 144 372 590 938 109 777 741 816