Pediatric Neck Impalement Injuries: A Report of Two Cases and Review of the Literature.

Authors

Ayaka Tsutsumi, Roxanna Hamidpour, Matthew Wagoner, Giovanni Ayala, Mehmet Erkilinc, Shin Miyata, Christopher Blewett

Published in

Cureus. Volume 18. Issue 6. Pages e111516. Epub Jun 25, 2026.

Abstract

Penetrating neck impalement injuries in children are rare but potentially life-threatening. We present two cases to illustrate the clinical spectrum of this injury pattern and reinforce key management principles. Case 1 was a 13-year-old female patient who sustained a wooden stick impalement to the right neck during a sledding accident. She was hemodynamically stable with a Glasgow Coma Scale (GCS) score of 15 and no neurological deficits. Computed tomography (CT) angiography showed a 2.5 cm soft tissue laceration with no vascular or aerodigestive injury. Case 2 was a 17-year-old female patient struck by a wire projectile from a lawnmower, presenting with immediate left upper extremity paresthesia but intact motor function and airway. CT confirmed a metallic foreign body traversing the spinal canal from T1-T2 to T2-T3 without vascular or aerodigestive injury. Both patients underwent operative removal of a foreign body under general anesthesia. Case 1 required wound irrigation and suture repair; she was discharged on oral antibiotics without complications. Case 2 underwent wire extraction with intraoperative neurophysiological monitoring and received targeted antibiotic prophylaxis given agricultural contamination. She was discharged neurologically intact with a cervical collar and orthopedic follow-up. These cases reinforce that pediatric neck impalement demands CT angiography prior to removal (if feasible), operative extraction in a controlled surgical setting, and vigilance for delayed complications, including carotid thrombosis, regardless of how benign the initial presentation appears.

PMID:
42504337
Bibliographic data and abstract were imported from PubMed on 27 Jul 2026.

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