Penetrerend halsletsel door steekverwondingen

In Nederland een zeldzaam maar complex probleem
Klinische les
12-06-2019
Dennis Hundersmarck, Paul J. van Koperen, Loek P.H. Leenen, Gert J. de Borst, R. Marijn Houwert en Falco Hietbrink

Dames en Heren,

Penetrerend halsletsel komt in Nederland weinig voor. Hulpverleners zien hierdoor weinig patiƫnten met dit potentieel lastige type verwonding. De literatuur hierover en de richtlijnen waar in Nederland gebruik van wordt gemaakt, zijn afkomstig uit buitenlandse centra waar men dagelijks met dit type letsel wordt geconfronteerd. Wat is de vereiste aanpak bij penetrerend halsletsel?

Penetrating neck injury caused by stabbing: a rare but complex problem in the Netherlands

Penetrating neck injuries (PNIs) as a result of stabbing or deliberate self-harm are complex and potentially life-threatening. Nowadays, selective non-operative management of PNI has become common practice. Diagnostic and treatment algorithms originating from high-volume trauma centres in South-Africa and North-America are used in Dutch clinical practice. Three patients that sustained a PNI are discussed. Two patients, aged 61 and 37, only had mild signs on physical examination that justified additional diagnostic investigations. In the first patient, a penetrating oesophageal injury was found and repaired. The latter had a partial Horner syndrome as a result of PNI, no underlying injuries were found. One patient, aged 57, was haemodynamically unstable and therefore received immediate surgical exploration of the neck. A penetrating injury of the jugular vein was discovered and repaired. A summary of literature and guidelines is presented for the benefit of Dutch physicians that may be confronted with these complex injuries.

Conflict of interest and financial support: none declared.