Laryngeal Transection in a Patient after Hanging

Abstract

Introduction: Hanging has become the second most common method of attempted suicide among adolescents and hanging injuries are associated with a high overall mortality rate. Laryngeal injuries were observed in 35% to 45% of victims of hanging at autopsy.
Case presentation: We present a 40-year-old male patient presenting after hanging. On presentation, he was alert with glasgow coma scale (GCS) 15/15 and self-ventilating, but was aphonic with quadriplegia. He suffered from complete upper laryngeal transection. He was successfully intubated in accident & emergency department (A&E), but eventually had tracheostomy with subsequent laryngeal repair. He was immediately transferred to neuro rehabilitation centre.
Conclusion: Airway injuries after hanging can be quite difficult to manage. Tracheostomy is recommended as the method of choice to secure the airway by many authors, because endotracheal intubation may pass into a false track at the site of tracheal separation and obstruct the airway completely.