Closed Wounds of the Chest and the Physician's Place in a Chest Team.--II

Thoracic wall foreign bodies following penetrating trauma in pediatric age group: report of two cases with literature review

“…These injuries may occur due to direct harm to the chest wall and history taken from the patient should include the mechanism of injury. Despite the notion that conservative management may be possible for most lung injuries, unremoved or forgotten FB following a trauma may produce parental anxiety and a great concern for their children (7)(8)(9). To leave the FB in chest wall may produce risk for an infection at future and because of this it has been generally admitted that FBs in the chest wall should be taken away immediately.…”

Impacted thoracic foreign bodies after penetrating chest trauma

“…An editorial comment in The Annals of Surgery in 1919 concerned 30 cases of projectiles retained in the chest; 15 symptomatic patients with major psychological concerns about a metallic foreign body embedded in their chest, underwent surgery. 4 In 1941, Nixon 5 tailored his conflict injury management according to the climate, soil, and weapons. He found a lower incidence of empyema in cases of retained bullets or shells than in cases with no retained foreign body in the chest (16% vs. 41%), and blamed rib fractures and soft tissue lacerations for sepsis, and the climate of the battlefield more than the nature of the weapon.…”

“…Most lung injuries can be managed conservatively. 2–5 There is a major debate about whether to remove an intrathoracic foreign body or to leave it in situ. To leave a foreign body in the chest is a concern to both the patients and their families.…”

“…The greatest risk is with large foreign bodies of more than 1.5 cm in diameter with sharp irregular fragmented edges and with severe lung contusions. 3–9 Many presentations to the annual meetings of the American Association for the Surgery of Trauma between 1961 and1963 recommended an aggressive surgical approach to treat gunshot wounds to the chest, but 2 years later, thoracotomy was advised only in cases not responding to conservative measures. 7,8 We present our experience of 90 cases of retained foreign bodies due to penetrating chest injuries.…”