Penetrating thoracic ice pick injury extending into pulmonary artery: Report of a case

• Published in: International journal of surgery case reports Vol. 52; pp. 63 - 66
• Main Authors: Kawaguchi, Marina, Yamamoto, Hirotsugu, Yamada, Taihei, Yumoto, Tetsuya, Aokage, Toshiyuki, Ihoriya, Hiromi, Eto, Koki, Suezawa, Takanori, Naito, Hiromichi, Nakao, Atsunori
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.01.2018; Elsevier
• Subjects: Case report; Emergency surgery; Penetrating chest injury; Pulmonary artery; Penetrating chest injury; Case report; Emergency surgery; Pulmonary artery
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2018.09.052

•A chest stab wound can have various clinical presentations ranging from no intrathoracic injury to life-threatening, extensive damage to the great vessels.•Early removal of the foreign body is recommended to prevent further damage to the heart.•Emergency physicians should seriously consider psychiatric consultation to prevent repeated suicidal attempts. Penetrating thoracic traumas have a wide spectrum, ranging from mild traumas to life-threatening injuries. This paper illustrates a 40-year-old male with a penetrating pulmonary artery injury that was successfully treated with emergency surgery. The patient visited local hospital by foot complaining of moving object on his chest and was found that an ice pick was penetrating the man's left chest. An ambulance took the patient to our emergency department. Computed tomography of the chest showed linear metallic density in the pulmonary trunk and a small amount of pericardial fluid. Emergency surgery for removal of the object and repair of the pulmonary artery was performed. The ice pick had been stuck in the main pulmonary artery through the pericardium without any injury to the left lung or internal thoracic artery. Postoperative course was uneventful. A multidisciplinary team designed our treatment strategy, enabling us to select the optimal treatment, including diagnostic techniques and surgical approach. A successful trauma management depends on whether a life-threatening conditionexists. Major vascular injury should be rapidly assessed in these cases. Psychiatric aspects of the case are also discussed. Early removal of the foreign body is recommended to prevent further damage to the heart.