# Penetrating Neck Injury: A Case Report and Review of Management

## TL;DR

This paper presents a case of a child with a neck injury and discusses the challenges and management strategies for such injuries.

## Contribution

The paper highlights the importance of individualized treatment and rapid airway management in pediatric penetrating neck injuries.

## Key findings

- A four-year-old girl with a cricoid membrane tear was successfully treated with selective surgery and airway stabilization.
- The case emphasizes the need for tailored interventions and multidisciplinary collaboration in managing pediatric PNIs.
- Current guidelines for PNIs remain ambiguous, requiring comprehensive assessment and timely actions.

## Abstract

Penetrating neck injuries (PNIs), although infrequent, are critical emergencies due to the intricate anatomy and presence of vital structures within the neck. PNIs are often caused by sharp objects or projectiles, posing a high risk of airway compromise or major vascular damage, leading to significant morbidity and mortality. Despite the severity of PNIs, international protocols for optimal management remain ambiguous, with most approaches still relying on zonal classification techniques. Traditional management strategies have shifted from mandatory surgical exploration to a more selective approach guided by clinical assessment and advanced imaging. Here, we report a case of a four-year-old girl with a PNI involving a cricoid membrane tear. The patient was successfully managed with selective surgical intervention and airway stabilisation via video laryngoscopic intubation. This case emphasises the challenges associated with PNIs in pediatric patients, highlighting the importance of individualised, timely interventions. The ambiguity in standardised guidelines underscores the need for comprehensive assessment and tailored treatment strategies. Our case also underscores the critical importance of rapid airway management, multidisciplinary collaboration, and preventive measures to mitigate risks, especially in young children.