Attempted Suicide by Cutthroat Laceration and Medication Overdose: A Case Report and Review of Current Literature

Background: Suicide rates continue to rise in the United States, with the majority increase being males with firearms. Drug-related suicides continue to rise as well, with overall drug overdose mortality increasing fivefold in the last 2 decades. Around 1.8% of trauma admissions are related to suicide attempts, with 30% of these occurring in the head and neck region. Self-inflicted cutthroat lacerations are a rare trauma mechanism. The management of these injuries, especially in zone II of the neck can be challenging. Timely identification and management of injuries in this zone are critical in limiting morbidity and mortality. Furthermore, concomitant drug overdose management may be necessary in the acute post-trauma setting. Toxicology interventions are not common practices in the trauma surgeon’s world, but are significant when providing comprehensive criticalcare. Case report: We share a case of a 50-year-old male with an ear-to-ear cutthroat laceration in zone II of the anterior neck, further complicated by medication overdose. Patient presented in distress, was taken to the operating room emergently for exploration and was discharged on postoperative day 7 without complication from his injury. We focus on the operative and postoperative management. We also include a brief review of concomitant toxicology management as these suicide attempt modalities are typically complicated by one another. Conclusion: Self-inflicted cutthroat lacerations are a rare form of penetrating neck trauma. These mechanisms have an elevated level of morbidity and mortality. Prompt operative investigation of associated injured structures is crucial for patient outcomes. These patients are further complicated by ingestion of toxic levels of medications and recreational drugs, for which the trauma team must be knowledgeable in treating.