Chest wall trauma leading to a metallic foreign body in the right subclavian vein: a case report

Migrated subcutaneous sharp foreign body in the anterior chest wall: An unusual presentation

Key Clinical Message

Migration of any foreign body can cause potentially life threatening complications and should be reviewed by a multidisciplinary approach for the management. Diagnosis can be challenging; a history of foreign body injury could be suspicious.

Abstract

Foreign body injury to the chest wall can be an emergency situation and require a multidisciplinary approach for the management of the condition. Migration of the foreign body, though rare, can lead to potentially life threatening complications and require a multidisciplinary approach for the localization of the foreign body and subsequent management of the condition. A 50-year-old male presented to the emergency department with the complaint of left sided chest pain. Upon examination, the patient was found to have a penetrating injury 6 years back by a sharp object. Radiological investigations helped in the localization of the migrating foreign body, which was removed with effective surgical intervention. The postoperative chest x-ray was normal, the patient was asymptomatic and thus the patient was discharged on the same day following surgery.

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

Penetrating chest trauma in children is an uncommon condition. Patients may be asymptomatic or in a critical state. Visceral and vascular damage are frequently present when penetrating objects enter the thoracic cavity. Although many studies have discussed penetrating thoracic trauma in adults, very few deal with the pediatric population. Here, we present the case of a 13-year-old child with an intrathoracic metallic bar after penetrating chest trauma. The clinical examination showed a stable patient with a palpable bar and subcutaneous emphysema in the left axillary area. The radiological scan did not reveal any vital damage. The bar was removed through the entry wound without thoracotomy or thoracoscopy. The patient evolved without any incident and was discharged after three days. Good improvement was noted over three months of follow-up. Intrathoracic foreign bodies secondary to penetrating trauma are rare in children. An exhaustive imaging examination is required to identify the precise location of the foreign material and find any severe organ or vascular injuries. If the condition permits, direct removal should be attempted in an operating room, in case surgical intervention is needed after the extraction.

An Unexpected 12.6 Centimeter Nail in the Thorax Damaging Vital Structures: A Case Report “Nailed It”

We report a patient who was referred to the emergency room with pulmonary complaints and where a computed tomography (CT) scan showed an unexpected 12.6 cm nail in the thorax penetrating part of the left pulmonary upper lobe, the left pulmonary artery, the left main bronchus, and the descending aorta, which had been in situ for at least three days. The quickly deteriorating patient had to be transferred to a tertiary academic hospital where the nail was successfully surgically removed. The comprehensive description of this unique case with a discussion of the critical decision moments could render insights into the management of challenging trauma cases.