A Case Report of Surgical Emphysema, Vocal Cord Palsy, and Pneumomediastinum Following Fishhook and Blunt Neck Trauma.

Surgical emphysema can be seen with tracheal or esophageal injuries. Physicians should consider the possibility of subtle esophageal or tracheal injuries and investigate accordingly. A 33-year-old previously healthy fisherman accidentally struck his neck with a fishhook while fishing and subsequently fell, sustaining combined blunt and penetrating trauma to the neck. In addition to a thorough medical examination, the patient underwent a chest X-ray, contrast-enhanced computed tomography (CECT), a barium swallow, and laryngobronchoscopy. The findings included extensive surgical emphysema, vocal cord palsy, and pneumomediastinum with no visible injuries to the aerodigestive tract. The patient was monitored and conservatively treated. The surgical emphysema subsided within the next four to five days, and the patient was discharged on the seventh day without any complications. A thorough clinical assessment, along with imaging, is essential to exclude life-threatening neck injuries. In hemodynamically stable patients with surgical emphysema and no radiological evidence of aerodigestive tract injury, conservative management with close monitoring can be an appropriate option.