Trauma to the neck: Manifestation of injuries outside the original zone of injury-A case report

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Submitted: February 2, 2018
Published: Feb 6, 2018
DOI: 10.29328/journal.acr.1001006
Keywords:
Trauma, Phrenic nerve pslsy, Hemidiaphragmatic paralysis, Pneumomediastinum, Anatomage, Clinical anatomy

Main Article Content

Alexander Christakis
Department of Pathology, Brigham and Women’s Hospital Boston, MA 02115, USA
Brian Tashjian
University of Massachusetts Medical School, Worcester MA 01655, USA
Anne M Gilroy
Department of Radiology, University of Massachusetts Medical School, Worcester MA 01655, USA
Stephen O Heard*
Department of Anesthesiology and Perioperative Medicine, University of Massachusetts Medical School and UMass Memorial Medical Center, Worcester MA 01655, USA

Abstract

A 53-year-old male presented to the Emergency Department (ED) with multisystem trauma and respiratory distress following a blunt-force injury to his anterior left neck. CT imaging showed extensive subcutaneous emphysema and pneumomediastinum. A chest X-ray showed elevation of the left hemidiaphragm suggesting phrenic nerve injury which was confirmed by bedside ultrasonographic examination of the left hemidiaphragm. Flexible bronchoscopy demonstrated tracheal rupture. The patient was treated supportively and recovered without surgical treatment. Trauma-induced hemidiaphragmatic paralysis is rarely reported. This case represents a clinical scenario with demonstrable anatomic correlations, and a clinical reminder that phrenic nerve injury should be included in the differential diagnosis of respiratory distress in a trauma patient.

Article Details

Christakis, A., Tashjian, B., Gilroy, A. M., & Heard, S. O. (2018). Trauma to the neck: Manifestation of injuries outside the original zone of injury-A case report. Archives of Case Reports, 2(1), 004–009. https://doi.org/10.29328/journal.acr.1001006
Case Reports

Copyright (c) 2018 Christakis A, et al.

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