Girl Hospitalized After Slipping And Impaling Her Neck On A Sharpened Pencil

A girl was hospitalized and given urgent surgery after she tripped and landed on a sharpened pencil, which penetrated her left common carotid artery. This artery supplies blood to the brain, neck, and face. 

The 11-year-old was playing during recess when she slipped and fell onto the pencil, which was left poking out of the left side of her neck. She was initially taken to a regional health center before being urgently transferred by ambulance to the Hospital for Sick Children in Toronto, Ontario, with the pencil still in place, her doctors write in BMJ Case Reports.

BMJ Case Reports 2019

There was no bleeding coming from the wound, and her vital signs were normal. Worryingly, the pencil was pulsating with her pulse. 

The doctors ordered a neck CT angiogram to see what was going on inside her neck, and found that the pencil was lodged in her left common carotid artery, causing a complete obstruction.

BMJ Case Reports 2019

She was taken to the operating room for surgeons to investigate the wound. Once inside, the surgeons identified and tagged the artery using vessel loops (the ties you can see in the photograph below), exposing the pencil.

BMJ Case Reports 2019

After she was given a dose of heparin (an anticoagulant) the doctors clamped her arteries and removed the pencil, before closing the wound.

She recovered well in hospital and was sent home just a few days later with painkillers to deal with the vast amounts of pain we'd imagine you'd feel after having your neck impaled with a 2B pencil.

She continued to recover and received ultrasounds six weeks later, then every six months for a year, and finally every year for two years. At three years, her ultrasound showed no sign of any abnormalities and she is otherwise quite healthy, if a little wary of art class or anything requiring a pencil.

Apart from falling on the pencil in the first place, she was lucky.

"These injuries can cause harm to the airway, digestive and neurovascular systems," the authors write in BMJ Case Reports. "While penetrating neck injuries in children are uncommon in comparison to adults, these injuries may be more devastating due to their smaller anatomy."

Whilst rare, these injuries are by no means unheard of. The authors refer to a previous study that found that between 2005 and 2009, 14 children had received "penetrating trauma caused by pens or pencils", with the events mainly affecting males and around 20 percent happening in schools.

Clothing hangers are also a threat, causing 394 head and neck injuries between 2002 and 2012.

And if you think you are safe in the bathroom, think again.

"A case of penetrating oropharyngeal trauma reaching the parapharyngeal space beyond the carotid vessels has been reported even with a typically benign item, such as a toothbrush."


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