A 28-year-old man sustains a stab wound to zone II of the neck. He is haemodynamically stable with no active hemorrhage. CT angiography shows complete transection of the right internal jugular vein with no arterial injury. The preferred management is:

• A Mandatory surgical exploration of zone II
• B Ligation of the internal jugular vein ✓
• C Observation only with serial examination
• D Primary repair of the internal jugular vein via lateral cervicotomy

Explanation

The internal jugular vein (IJV) can be safely ligated unilaterally — the contralateral IJV and collateral venous drainage compensate adequately. In penetrating neck trauma, the 'selective surgical approach' now predominates over mandatory exploration for zone II injuries in stable patients with CTA guidance. When IJV injury is confirmed and requires intervention, ligation is the standard treatment — primary venous repair is technically complex and not required given the collateral venous system.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.