Non-operative management of a case of pneumopericardium and vascular injury in the neck following penetrating trauma: A challenge to the trauma surgeon

Successful non-operative management (NOM) of penetrating injuries requires intensive patient monitoring and the immediate availability of advanced imaging and facilities for radiological interventions. We report a patient with multiple penetrating chest and neck injuries, including a traumatic pneumopericardium and a neck hematoma. While the focus was on the traumatic pneumopericardium, the neck injury manifested as a delayed vascular lesion and bleeding. However, both injuries were managed successfully non-operatively. This case emphasizes that NOM of multiple life-threatening penetrating injuries should be attempted in a facility with appropriate resources and that a multidisciplinary approach is crucial. We need to give equal importance to each injured region, with particular attention to the patient’s physiology.