Zone II neck trauma with a stable, asymptomatic patient — the current evidence-based approach favours:
- A Mandatory operative exploration regardless of symptoms
- B CT angiography as the primary diagnostic modality, with selective surgery ✓
- C Observation alone for 48 hours
- D Conventional angiography as the first-line investigation
Correct answer: B. CT angiography as the primary diagnostic modality, with selective surgery
Explanation
Modern management of penetrating Zone II neck injuries (between cricoid and angle of mandible) in haemodynamically stable, asymptomatic patients has shifted from mandatory exploration to selective management guided by CT angiography, which has near 100% sensitivity for vascular injury and identifies aerodigestive injuries. Mandatory exploration historically had a negative exploration rate of 50–60%. Hard signs (active haemorrhage, expanding haematoma, shock, bruit, neurological deficit, airway compromise) mandate immediate surgery.
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.