European Archives of Oto-Rhino-Laryngology

, Volume 272, Issue 12, pp 3825–3831 | Cite as

Sharp neck injuries in suicidal intention

  • Damien Biétry
  • Aristomenis Exadaktylos
  • Thomas Müller
  • Peter Zbären
  • Marco Caversaccio
  • Andreas Arnold
Head and Neck


Sharp neck injuries in suicidal intention often present as serious emergency situations with the need for an immediate diagnosis and treatment. We report our study of the clinical evolution of this emergency condition. This study investigates the cases of sharp neck injuries in suicidal intention treated at our institution between 2000 and 2010. Patient records were collected in a retrospectively reviewed and analyzed database. The current literature was compared to our findings. We found 36 cases (10 female and 26 male). The neck injuries were superficial and profound in 16 and 20 patients, respectively. Twenty-two patients were seen by the Head and Neck surgeon. A surgical neck exploration was necessary in 19 cases. Tracheal, laryngeal, pharyngeal and vascular injuries were found in one, five, three and three cases, respectively. The hospital stay ranged from 1 to 47 days. All the patients underwent emergency psychiatric assessment and were subsequently referred for psychiatric treatment. One patient died in the emergency room from an additional arterial injury to the wrist. Sharp neck injuries in suicidal intention treated with an interdisciplinary medical, surgical and psychiatric emergency assessment and treatment have low mortality and morbidity.


Neck injuries Suicide Stabbing Cutting Sharp injury 



We thank Christian Wolf for his kind assistance in formatting the document and figures.

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Suicide rates per 100,000 by country, year and sex (Table) []
  2. 2.
    Number of deaths and standardised mortality rates by age groups per 100,000 inhabitants (Table) []
  3. 3.
    Reisch T, Steffen T, Maillart A, Michel K (2010) Suicide attempts in the county of Bern between 2004 and 2010: results from the WHO//MONSUE multicentre study on suicidal behaviour. In: Swiss Federal Office of Public Health FOPHGoogle Scholar
  4. 4.
    Fukube S, Hayashi T, Ishida Y, Kamon H, Kawaguchi M, Kimura A, Kondo T (2008) Retrospective study on suicidal cases by sharp force injuries. J Forensic Leg Med 15:163–167CrossRefPubMedGoogle Scholar
  5. 5.
    Eberhardt MS, Ingram DD, Makuc DM (2001) Suicide. In: Urban and Rural Health Chartbook Health, United States, Hyattsville, Maryland, National Center for Health Statistics. p 58Google Scholar
  6. 6.
    Beautrais AL (2000) Risk factors for suicide and attempted suicide among young people. Aust N Z J Psychiatry 34:420–436CrossRefPubMedGoogle Scholar
  7. 7.
    Brywczynski JJ, Barrett TW, Lyon JA, Cotton BA (2008) Management of penetrating neck injury in the emergency department: a structured literature review. Emerg Med J 25:711–715CrossRefPubMedGoogle Scholar
  8. 8.
    Dupanovic M, Fox H, Kovac A (2010) Management of the airway in multitrauma. Curr Opin Anaesthesiol 23:276–282CrossRefPubMedGoogle Scholar
  9. 9.
    Erhart J, Mousavi M, Vecsei V (2000) Penetrating injuries of the neck, injury pattern and diagnostic algorithm. Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizin 71: 1138–1143Google Scholar
  10. 10.
    Maier H, Tisch M, Lorenz KJ, Danz B, Schramm A (2011) Penetrating injuries in the face and neck region. Diagnosis and treatment. HNO 59:765–782CrossRefPubMedGoogle Scholar
  11. 11.
    Herzog M, Hoppe F, Baier G, Dieler R (2005) Injuries of the head and neck in suicidal intention. Laryngorhinootologie 84:176–181CrossRefPubMedGoogle Scholar
  12. 12.
    American College of Surgeons Committee on Trauma (2004) Advanced trauma life support program for doctors, 7th edn. American College of Surgeons, ChicagoGoogle Scholar
  13. 13.
    Roon AJ, Christensen N (1979) Evaluation and treatment of penetrating cervical injuries. J Trauma 19:391–397CrossRefPubMedGoogle Scholar
  14. 14.
    Flavio M, Martin E, Pascal B, Stephanie C, Gabriela S, Merle K, Anita RR (2013) Suicide attempts in the county of Basel: results from the WHO/EURO multicentre study on suicidal behaviour. Swiss Med Wkly 143:w13759PubMedGoogle Scholar
  15. 15.
    Sebestyen B, Rihmer Z, Balint L, Szokontor N, Gonda X, Gyarmati B, Bodecs T, Sandor J (2010) Gender differences in antidepressant use-related seasonality change in suicide mortality in Hungary, 1998–2006. World J Biol Psychiatry 11:579–585CrossRefPubMedGoogle Scholar
  16. 16.
    LA Dumais A, Lalovic A, Séguin M, Tousignant M, Chawky N, Turecki G (2005) Is violent method of suicide a behavioral marker of lifetime aggression? Am J Psychiatry 162:1375–1378CrossRefPubMedGoogle Scholar
  17. 17.
    Beautrais AL (2002) A case control study of suicide and attempted suicide in older adults. Suicide Life Threat Behav 32:1–9CrossRefPubMedGoogle Scholar
  18. 18.
    Asberg M, Traskman L, Thoren P (1976) 5-HIAA in the cerebrospinal fluid. A biochemical suicide predictor? Arch Gen Psychiatry 33:1193–1197CrossRefPubMedGoogle Scholar
  19. 19.
    Burgess CA, Dale OT, Almeyda R, Corbridge RJ (2012) An evidence based review of the assessment and management of penetrating neck trauma. Clin Otolaryngol 37:44–52CrossRefPubMedGoogle Scholar
  20. 20.
    Sarkar D, Demma A, Stulz D, Hsue G (2009) Expect the unexpected: two cases of penetrating head and neck trauma from Operation Iraqi Freedom. Ear Nose Throat J 88:E19–E21PubMedGoogle Scholar
  21. 21.
    Karger B, Niemeyer J, Brinkmann B (2000) Suicides by sharp force: typical and atypical features. Int J Legal Med 113:259–262CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Damien Biétry
    • 1
  • Aristomenis Exadaktylos
    • 2
  • Thomas Müller
    • 3
  • Peter Zbären
    • 1
  • Marco Caversaccio
    • 1
  • Andreas Arnold
    • 1
  1. 1.Department of Otorhinolaryngology, Head and Neck Surgery InselspitalUniversity of BernBernSwitzerland
  2. 2.Department of Emergency Medicine, InselspitalUniversity of BernBernSwitzerland
  3. 3.University Hospital of Psychiatry, University of BernBernSwitzerland

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