Transcervical gunshot injuries: Mandatory operation is not necessary

D. Demetriades, D. Theodorou, E. Cornwell, J. Asensio, H. Belzberg, G. Velmahos, J. Murray, T. V. Berne

Research output: Contribution to journalArticle

62 Scopus citations

Abstract

Background: It has been suggested that all transcervical gunshot wounds should be explored surgically because of the high incidence of injuries to vital structures. The present prospective study investigated the clinical presentation, the role of various diagnostic investigations, and the need for surgery in patients with transcervical gunshot injuries. Methods: Ninety- seven patients sustained gunshot injuries to the neck and 33 of them (34%) were transcervical. All victims were assessed clinically according to a written protocol and subsequently were evaluated angiographically, and, in the appropriate case, by means of endoscopy and esophagography. Results: Overall, 24 (73%) of the 33 patients with transcervical gunshot wounds had injuries to cervical structures. Vascular injuries were found in 48%, spinal cord injuries in 24%, and aerodigestive tract injuries in 6% of patients with transcervical injuries. In the 64 patients without midline crossing, the incidence of cervical structure injuries was 31%. Despite the high incidence of injuries to cervical structures in transcervical wounds, only 21% of the patients had a therapeutic operation. The overall mortality was 3%. There were no in-hospital deaths or local complications in the nonoperatively managed group. Conclusions: The results of the present study do not support the current recommendations of mandatory operation for all transcervical gunshot wounds. A careful clinical examination combined with the appropriate diagnostic investigations should determine the treatment modality. About 80% of these patients can safely he managed nonoperatively.

Original languageEnglish (US)
Pages (from-to)758-760
Number of pages3
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume40
Issue number5
DOIs
StatePublished - May 1996

All Science Journal Classification (ASJC) codes

  • Surgery
  • Critical Care and Intensive Care Medicine

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    Demetriades, D., Theodorou, D., Cornwell, E., Asensio, J., Belzberg, H., Velmahos, G., Murray, J., & Berne, T. V. (1996). Transcervical gunshot injuries: Mandatory operation is not necessary. Journal of Trauma - Injury, Infection and Critical Care, 40(5), 758-760. https://doi.org/10.1097/00005373-199605000-00012