PMC6368990_01
Picture showing penetrating neck injury entry site
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PMC6368990_01_ijo-31-065-g001.jpg
F1
On neck examination, there was an open wound, about 0.5 x 0.5 cm in size, in the lower third anterior aspect of the neck with surrounding neck swelling and tenderness (Fig.1).
a) X-ray soft tissue neck lateral view showing the radio-opaque foreign body located in the tracheoesophageal party wall at the C6-C7 level with air lucency noted in the prevertebral space. b) CECT scan neck showing radio-dense metallic foreign body located in the trachea-esophageal party wall with air dissection in the subcutaneous plane
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F2
A soft tissue neck (STN) lateral view revealed a radiopaque foreign body shadow at the level of the C6-C7 vertebral body level (Fig.2a). This was further confirmed with contrast enhanced computed tomography (CECT) of the neck with fine 1-mm cuts, which also showed that the radio-dense foreign body lodged in the tracheoesophageal party wall at the level of second and third tracheal rings, corresponding to the C7 vertebral body (Fig.2b).
a) Image showing neck exploration by extending tracheostomy skin incision superiorly and tracheal entry site of the foreign body (arrow).  b) Removed metallic foreign body
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PMC6368990_01_ijo-31-065-g003.jpg
F3
The small entry point was found on the anterior wall of the second tracheal ring (Fig.3a). The foreign body was gently removed, avoiding accidental slippage into the distal airway (Fig.3b). 