Management and Outcomes of Aerodigestive Injuries in Penetrating Neck Trauma in Yemen

Abstract

Background: Penetrating neck trauma (PNT), involving the aerodigestive system, is a life-threatening condition. Effective management is crucial, particularly in resource-limited conflict zones.

Objective: To evaluate the management and outcomes of PNT at a military hospital in Sana’a, Yemen.

Methods: We retrospectively reviewed the records of 50 patients who underwent PNT (January 2018 and March 2023). This analysis included 30 patients with confirmed aerodigestive tract injuries.

Results: All patients were male (90% aged 20–30 years). Gunshot wounds (67%) predominated, with 77% presenting within 24 h; all were Zone II injuries. The most common signs were dyspnea (50%) and dysphagia (59%). Surgical exploration was indicated in 50% of patients. Single-structure injuries (77%) primarily involved the pharynx (53%) or larynx (43%). Pharyngeal injuries were often managed conservatively (63%), and all patients with esophageal injuries required surgical repair. Postoperative infections occurred in 13% (airway) and 17% (digestive) of cases. The overall survival rate was 96.7%, with 66.7% of patients surviving without morbidity, 30% surviving with morbidity, and 3.3% mortality.

Conclusion: Despite significant infection rates, high survival rates are achievable in this resource-limited conflict setting. Context-specific protocols that prioritize rapid pre-hospital care, multidisciplinary management, and robust infection control are vital.