PMC9527837_01
Abrasion wound of 4 mm x 3 mm (black arrow)
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Clinical examination revealed an abrasion (4 mm x 3 mm) about 2 cm below the mandibular body margin at the anterior border of the sternocleidomastoid muscle [Figure 1].
(a) Plain radiograph neck lateral view showing radiopaque linear shadow at C1-C2 vertebra level (black arrow), (b) Contrast-enhanced CT scan neck (3D reconstruction) showing close proximity of vital structures to the radiopaque linear foreign body, (c) C-arm X-ray confirms the site of foreign body intraoperatively
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The two marker pins with heads are the artifacts in the radiograph [Figure 2a]. There was no evidence of haematoma and carotid vessels appeared normal [Figure 2b]. Multiple C-arm X-rays were done to locate and confirm the site of the foreign body intraoperatively [Figure 2c].
Intraoperative marking of anatomical landmarks
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An approximate 3 cm incision was made 2 finger-widths below the angle of the mandible at the level of the anterior margin of the sternocleidomastoid muscle on the right side, after confirming with the C-arm X-ray [Figure 3].
Neck dissection under GA to remove the foreign body
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The foreign body (sewing needle) was found to be embedded in the soft-tissue approximately 1.6 cm deep to the skin lying in juxtaposition with the IJV, piercing its adventitia, though the lumen was not entered [Figure 4].
A 2.8 cm long needle removed after dissection
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The foreign body was removed carefully [Figure 5].