Diagnostic Approach to Penetrating Neck Trauma: What You Need to Know

J Trauma Acute Care Surg. 2024 Mar 25. doi: 10.1097/TA.0000000000004292. Online ahead of print.


Diagnostic evaluation of penetrating neck trauma has evolved considerably over the last several decades. The contemporary approach to these injuries is based primarily on clinical signs of injury and multidetector computed tomographic angiography (MDCTA). The neck is evaluated as a unit, rather than relying on the surface anatomy zones in which external injuries are seen to guide the workup of internal injuries. This "no-zone" approach safely spares many patients from negative explorations and unnecessary invasive tests. The purpose of this review is to describe an evidence-based approach to the diagnostic evaluation of penetrating neck trauma, including indications for adjunctive testing beyond physical exam and MDCTA.