Penetrating chest trauma caused by a falling metallic bar: a case report

Abstract

Background Impaling injuries to the chest are relatively rare and often lethal. Initial evaluation, resuscitation, and surgical planning can be challenging for emergency physicians and surgeons. Chest trauma can be classified as either closed or penetrating, depending on whether or not the pleural cavity is open. Penetrating objects entering chest cavity frequently make an entrance and exit and are often accompanied by visceral/vascular damage. Open thoracotomy or video-assisted thoracic surgery (VATS) are considered the first-line approaches for severe penetrating chest trauma. Case Description A 63-year-old male patient sustained a penetrating chest trauma caused by a T-shaped metallic bar falling from a height of 16 meters above the ground. After laboratory and imaging tests, as well as pre-operative preparation, the object was pulled out from the entry site after disinfection with surgical standby. Closed chest tube drainage was promptly performed, with chest tubes inserted through the entry and exit sites. The patient was discharged on postoperative day 14 in a good condition. Regular telephone follow-ups over 3 years showed that the patient recovered well after discharge. Conclusions For penetrating non-cardiac chest trauma patients in stable condition, it is necessary to complete an exhaustive imaging evaluation to determine the specific position of the foreign body and identify any injuries to major vessels and organs. If the condition permits, direct removal of foreign bodies is allowed, ideally under VATS control. Surgeons should evaluate the best option for each case based on the available resources.

Penetrating Chest Trauma in a Child Caused by a Fall on a Metallic Bar: A Case Report

“…Thoracotomy has long been considered the standard treatment for major thoracic trauma involving foreign bodies [ 4 ]. However, the large incisions involved in thoracotomy might be associated with significant morbidity and hospitalization [ 4 , 9 ].…”

“…Thoracotomy has long been considered the standard treatment for major thoracic trauma involving foreign bodies [ 4 ]. However, the large incisions involved in thoracotomy might be associated with significant morbidity and hospitalization [ 4 , 9 ]. Since its appearance, thoracoscopy has become a safer approach for the management of stable patients, and thoracotomy is recommended in cases of hemodynamic instability [ 4 ].…”

“…Efficient evaluation and identification of patients requiring surgical intervention is imperative. The approach in such circumstances must always consider the dangers associated with removing the object and the potential complications [ 4 ].…”