Near-fatal Self-Inflicted suicidal Cut Throat Injury with open airway; a case report and review of the literature.

Abstract

Cut-throat injuries can be homicidal, suicidal, or accidental. Self-inflicting suicidal cut injuries in adults are less common than in the young age groups. It happens in adults after being neglected at home, frustration, financial crisis, anxiety, and depression. We present a 61 years old male who was brought to the emergency early in the morning immediately after a self-inflicted cut-throat injury with clinical features of aspiration, bleeding, and breathing from the neck. On examination, there was a 7 cm cut injury in between the thyroid cartilage and the hyoid bone. The whole anterior wall of the laryngopharynx and larynx were transected leading to the visualization of supra-glottis and the posterior wall of the hypopharynx. A computerized tomography scan of the head and neck was performed to rule out head injuries and extension of the cut injuries at the neck. Emergency tracheostomy, followed by primary repair of the injuries were done. During the postoperative period, patient had difficulty with speech and swallowing. After almost three weeks of rehabilitation by the team, the patient was discharged. The patient was able to speak and swallow with a reduced level of anxiety. This case report highlights the emergency management of open airway suicidal cut injury, its immediate surgical management, post-operative rehabilitation of speech and swallowing, and re-establishment in the society.