Abstract
Penetrating neck injuries (PNIs) are rare, but may be potentially lethal. The management of PNIs remains controversial. We report a case of surgical repair of the left carotid arteriovenous fistula after penetrating injury of the neck. A 34-year-old woman, who stabbed herself in the neck was admitted to the emergency medical center. She did not have active bleeding or hemodynamic instability, then had the stab wound just closed. On the following day, continuous murmur was audible at the left neck and contrast CT scan revealed a pseudoaneurysm of the left common carotid artery. The patient was referred to our hospital, and had an emergency operation. The operation was performed through a left cervical incision and median full sternotomy to control bleeding at the take off of the left common carotid artery. We used topical head cooling and continuous intravenous injection of thiopental to protect the brain. Both the left carotid artery and the internal jugular vein were repaired by direct suture closure. Clamp time of the left common carotid artery was 30 minutes. No postoperative neurologic deficit occurred and her postoperative course was uneventful.
