Fig. 2

a Axial image of MDCTA performed on a 33-year-old man who sustained a stab injury to left zone 2. The platysma has been breached (arrow) and there is soft tissue emphysema in the deep cervical fascia surrounding the left carotid sheath. No major vascular injury or upper aerodigestive tract penetration was present. There was no pneumothorax. b Axial image of MDCTA through zone 1 on lung-window settings of a different patient who sustained left zone 2 penetrating knife injury with breach of platysma (image not shown). Diffuse soft tissue emphysema is noted in the deep cervical fascia bilaterally in zone 1 despite penetrating wound entry in left zone 2. This can be a common finding in penetrating neck injury where platysma has been breached even in the absence of perforation of the upper aerodigestive tract or pneumothorax. Nevertheless, penetration of the laryngopharynx should be further excluded where clinical and radiological suspicion is high. (Contrast swallow was negative in this patient)