Doctors save man pierced in a freak accident by 5-feet long rod through the neck

 

 

Sagaya Fernando

Mumbai: 6 November 22

 

A team of doctors at Apollo Multispecialty hospital in Triuchirappalli, Tamil Nadu, India, saved the life of a 33-years-old man whose neck was pierced through by a feet long iron rod.

 Karthikeyan, a resident of Ariyamangalam in the city, was watering the concrete slabs on the first floor of his under-construction house when he accidentally slipped and fell 15 to 20 feet down, on October 15. As he fell, a 5 feet long iron rod with serrated edges pierced through his neck and came out from the back.

 “Within fifteen minutes of the mishap, his relatives rushed him to our hospital which is in close vicinity,” informed Apollo Multispecialty Hospital, Triuchirappalli, Consultant General, Laparoscopic and Bariatric Surgeon Dr Mohamed Mansoor, who led the operating team.

 “On evaluation in emergency, it was seen that he had a 5 feet long iron rod penetrating into the anterior aspect of neck and exiting the posterior aspect of neck. After initial stabilization of the patient by the emergency team, a plan was chartered out to remove the iron rod by involving a team of specialists. We were not able to do any sort of imaging / x-ray of the wound as it would have created an artifact (distortion). So only a bedside ultrasound was done to ensure no major vascular injury,” said Dr Mansoor.

 “The rod was there shortened on either sides with the help of maintenance engineers in the hospital. Shorting of the rod was the only option available to ensure safe mobilization of the patient as the rod would make it difficult to enable us to subject him to any form of scanning or interventions. The patient was immediately shifted to the operating room for surgery. This was a challenging surgery as neck is the complex region, which has important structures like trachea (wind pipe), esophagus (food pipe), major vessels supplying to the brain (carotid artery). A team of specialists ensured that none of the major organs or vessels in the neck was injured,” said he.

 An on table Tracheostomy was done anticipating postoperative complications, by Consultant ENT Dr Ajay Manickam, while the surgery was ably supported by Consultant Plastic Surgeon Dr Vidhun Raj Bharat and Consultant Vascular Surgeon Dr C Anand. Airway management was challenging and was handled by anaesthesiologists Dr Karthick and Dr Alagappan, while Dr Muralirangan performed an ontable endoscopy to ensure no esophageal injury.

 

In the follow-up tests, it was found that the patient had developed aspiration pneumonitis caused by gastric contents entering into the lungs, which was managed conservatively by consultant pulmonologist Dr V Tamilarasan.

 

The entire surgical procedure lasted about three hours during which the medical team led by Dr Mansoor successfully removed the rod without causing any further injury.

 

All clinical parameters stabilized and necessary scans were performed to ensure no residual injuries were present. Postoperatively he was managed in the ICU and later weaned off the ventilator. The tracheostomy incision was subsequently closed at a later date, and the patient was discharged on October 23. On November 5, all his sutures were removed, and he is perfectly fine now, said Dr Mansoor.

 

“Cases of grievous neck injury such as this as are rare, and survival rates are quite low in our state. The patient was really lucky to have been brought to hospital quickly and also to have his voice unaffected by the accident. As surgeons, we had to ensure that the rod was removed with precision, with no residual contents left behind. We hope that the public will treat this as a cautionary incident and be careful on construction sites,” said Dr. Mansoor.