Management of an Unusual Penetrating Neck Injury with an Iron Rod in a Tertiary Care Centre

The majority of the neck injuries are linked either to aggression or self inflicted cut throat or firearm injuries. Here we present a rare case of a penetrating neck injury by an iron rod, which was sustained due to accidental fall at home. A very long, rusted, iron TMT bar about 10 mm diameter, with entangled clothing with hooks on it, had penetrated the neck of the patient from below the mandible in the left side and exited through the oral cavity on the right angle of the mouth. The patient was under alcohol intoxication, however was stable as far as vital signs were concerned. There was no active bleeding or expanding haematoma neither there was any stridor or neurological deficit.

The patient was further stabilised and after doing the necessary investigations he was taken up for surgery under general anaesthesia and the rod was successfully removed and the wound repaired. The patient recovered uneventfully and quickly and was discharged on the fifth post operative day.

Accidental penetrating neck injuries are not very common and internet search did not reveal many published cases. Penetrating neck injuries are usually attached with high morbidity and mortality, because of damage to great vessels and nerves. A good knowledge of the anatomy and proper assessment of the injury before removal is a prerequisite before removal. With a little bit of courage and adopting a multidisciplinary approach and good computed tomography (CT) scan to assess the injury, such cases can be easily handled.