PHYSICAL-EXAMINATION AND SELECTIVE CONSERVATIVE MANAGEMENT IN PATIENTS WITH PENETRATING INJURIES OF THE NECK

This prospective study of 335 patients with penetrating injuries of th e neck examined the decision whether to operate or observe according t o a protocol bused mainly on physical examination. Emergency angiograp hy was performed in only three patients. Sixty-six patients (20 per ce nt) were subjected to emergency operation because of signs and symptom s suggestive of significant injury (60 patients) or because of positiv e investigations (six). The remaining 269 patients (80 per cent) were selected for non-operative management. Two of these patients (0.7 per cent) required elective operation during the initial hospital stay. No deaths occurred in patients treated conservatively. Some 192 (72 per cent) of observed patients,were available for early follow-up and 111 (42 per cent) for late follow-up. No significant complications rr!ere found Physical examination is a reliable method for detecting signific ant injuries following penetrating neck trauma. Emergency angiography is rarely necessary.