An 85-year-old ventilator-dependent male was endotracheally intubated 10 days ago. He remains unresponsive and is not a candidate for early extubation. The intensive care unit (ICU) attending elects to perform tracheostomy at the bedside. During the procedure, copious dark blood is encountered. This is most likely due to transection of which of the following:

Correct Answer: Anterior jugular vein
Description: The anterior jugular vein can cross the mid-line overlying the proximal trachea. Midline cervical dissection without adequate visualisation can injure the vein and require open surgical repair. The other veins do not cross the midline and are not generally at risk in tracheostomy.
Category: Surgery
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