Self‐inflicted stab wound at first thoracic vertebra

Abstract

Self-stabbing is an uncommon method of suicide, accounting for only 1%-3% of suicide attempts. Among these, 40% involve a penetrating neck injury. 1,2 We present the case of a 64-year-old woman who stabbed her neck with a kitchen knife in an attempt to commit suicide. On examination, she was stable and conversant (Figure 1A). Post-intubation computed tomography (CT) revealed a cervical vertebral wound, and damaged anterior and posterior tracheal walls. The tip of the knife was chipped and lodged into the first thoracic vertebra. No pneumothorax and extravascular leakage, suggestive of damage to the cervical arteriovenous system, were noted (Figures 1B,C). An emergency operation was performed to remove the knife. The lodged knife tip was removed by scraping the vertebral body with a drill (Figure 1D). The thyroid isthmus and the anterior and posterior walls of the trachea were sutured. Tracheal stenosis was noted postoperatively. She was discharged on postoperative day 39 without complications. Patients with stab wounds are hemodynamically stable on admission because blades serve as local tamponades. Spiral computed tomography is an essential diagnostic modality for patients with stab wounds on the