Penetrating Neck Trauma

Annotation for Point H

In those patients with Zone I and II injuries who undergo CTA evaluation without direct evidence of aerodigestive tract injury but secondary to wound trajectory, proximity to other injuries, or any evolving symptoms, should undergo additional evaluation. Some controversy regarding the sensitivity of esophagography, rigid esophagoscopy, flexible esophagoscopy, or a combination of these studies exists in the literature.47-50 Current practice guidelines recommend that esophagography or esophagoscopy can be used to rule out esophageal injury and add that an expeditious evaluation should occur owing to the increased morbidity associated with delayed esophageal repair.4,42