American Board of Surgery Qualifying Exam (ABS QE) Practice Test

What is the recommended approach for managing thyroid trauma or injury?

1. Thyroidectomy

2. Ligate and drain

3. Immediate exploration

4. Monitoring without intervention

The correct answer is: Ligate and drain

When managing thyroid trauma or injury, ligation and drainage is often the recommended approach in cases where there is a significant hematoma or the presence of a pseudocyst, as these conditions can lead to airway compromise or thyroid dysfunction. This technique allows for the evacuation of blood or other fluid collections, which alleviates pressure on surrounding structures, particularly the airway. It's also important for physicians to consider the extent and nature of the injury. For minor injuries without significant hematoma or complications, close monitoring may be appropriate. Nevertheless, if there are signs of compression or instability, drainage becomes critical to prevent further complications. Immediate exploration is typically reserved for cases where there is a concern for significant vascular injury or extensive tissue damage, but this is less common than the use of ligation and drainage. Thyroidectomy would only be performed in more severe cases where there is damage to the thyroid gland itself necessitating removal. In summary, ligating and draining any major hematomas or collections provides an immediate solution to manage the complications associated with thyroid injuries, which is why this approach is favored in clinical practice.