A 20-year-old man sustains a Zone I neck stab wound below the cricoid cartilage. He is hemodynamically stable with no airway compromise, active bleeding, or expanding hematoma. What is the most appropriate next step in evaluation?
- A CT angiography of the neck ✓
- B Immediate surgical exploration
- C Barium swallow study
- D Observation with serial examinations alone
Correct answer: A. CT angiography of the neck
Explanation
Zone I injuries in stable patients without hard signs of vascular injury should be evaluated with CT angiography to assess for great vessel and thoracic duct injury. Surgical exploration is indicated for hard signs such as active hemorrhage, expanding hematoma, or shock. Observation alone risks missing occult vascular injury.
Reference: Trauma, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.