Highlights Acute surgical abdomen has a limited differential in pediatric population. Meckel’s diverticulum can mimic the clinical findings of acute appendicitis. Careful radiographic review to identify the appendix in the pediatric population with acute abdomen. Surgical pathology of a normal appendix and a perforated Meckel’s Diverticulitis, with a retrospective view of the appendix.

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Traumatic injury to the mediastinum can damage critical surrounding structures, including the pericardium, aorta, and bronchial tree. We highlight a miraculous case of a 13-year-old female with no past medical history who presented to the emergency department after being impaled in the chest by a metal fence post. After median sternotomy, the foreign object was removed, and the patient fortunately recovered with no permanent sequelae. The radiographic features of the injury are described, and potential unseen cardiovascular and respiratory complications are discussed.