Penetrating Injuries of the Neck Guidelines

Updated: Jun 11, 2018
  • Author: Aru Panwar, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Guidelines

Guidelines Summary

The American College of Radiology Appropriateness Criteria for penetrating neck injury, published in 2017, include the following recommendations [18] :

  • In patients with penetrating neck injuries with clinical soft injury signs and in patients with hard signs of injury who do not require immediate surgical exploration, CT angiography of the neck is the preferred imaging procedure to evaluate the extent of injury
  • When a clinical concern remains for vascular injury despite a normal or equivocal CT angiography scan of the neck, catheter-based arteriography is useful for further evaluation; the benefit of arteriography is the ability to perform, in tandem, an endovascular procedure if needed
  • If a concern remains for aerodigestive injury despite a normal or equivocal CT angiography scan of the neck, a radiographic single-contrast esophagram may be considered, but it should be used in conjunction with direct visualization techniques