Mediastinal impalement with a fibreglass sheet

Object impaled in the Thorax: Review Study

“…4, It is noteworthy, however, that diaphragmatic injury was present in 15.62% of patients, indicating abdominal injury. 2,9,12,16,26 In that group, all of the patients had intraabdominal organ injury (4 liver injuries, 1 splenic injury, and 2 hollow viscous injuries). Some studies described only the most significant injuries, whereas other studies did not describe the injuries, which may explain the low incidence of pulmonary lesions.…”

“…Regarding treatment, 21 patients underwent thoracotomy, and only 5 were unstable upon admission. [1][2][3][4][7][8][9][10][11][12][13]15,[19][20][21][22][23][24][25][26][27] Another therapeutic option carried out was removal of the impaled object under thoracoscopy (5 patients), 6,[14][15][16]18,24 and all of these patients were stable upon admission. Finally, 7 patients underwent direct removal of the penetrating object with thoracic drainage (1 patient being treated with the assistance of thoracoscopy on the right side and by direct removal on the left side).…”

Near miss for big red: a unique case of penetrating glass injury of the thoracic spine and posterior mediastinum

“…6 Care of impalement injury patients begins in the pre-hospital setting. 2,3 Any foreign body should be left in place and great care should be taken to avoid manipulation of the object to limit further injury or exsanguination. 2,3 When patients arrive in the emergency department, we believe the trauma surgery service should be the first to evaluate the patient in accordance with Advanced Trauma Life Support protocols and then engage all appropriate specialties.…”

“…2,3 Any foreign body should be left in place and great care should be taken to avoid manipulation of the object to limit further injury or exsanguination. 2,3 When patients arrive in the emergency department, we believe the trauma surgery service should be the first to evaluate the patient in accordance with Advanced Trauma Life Support protocols and then engage all appropriate specialties. The reason for this is twofold: first, penetrating injuries may affect multiple organ systems for which the trauma surgeon is best-equipped to workup and prioritize therapies; second, the trauma team can then quickly involve consultants and initiate multidisciplinary discussion with regards to the appropriate surgical care of the injury.…”

“…Although past case reports have described isolated penetrating injuries to the spine and mediastinum, to our knowledge, there has never been a reported case of simultaneous mediastinal and spinal column glass injury. [2][3][4][5][6] This case presentation poses several unique management challenges in patients presenting with low-velocity penetrating injuries. We successfully managed this patient in multidisciplinary manner with planned diagnostic workup and sequenced surgical procedures.…”