A Case of Delayed Traumatic Hemothorax Occured 8 Months After Trauma

Kakishita, Tomokazu; Kawai, T; Higashi, Ryohei

doi:10.3919/jjsa.65.2329

Cited by 4 publications

(8 citation statements)

References 4 publications

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“…Scars resulting from glass shard injuries may gradually shrink over time 15 and wounds caused by glass impalement are often superficially cleaned without an in-depth assessment of potential foreign body retention. In fact, there are at least 7 known cases where relatively large glass shards deep within the body were overlooked 8,17,18,37,60,62–64 …”

Section: Discussionmentioning

confidence: 99%

“…Traumatic damage to the parietal pleura often results in certain expected consequences such as pleural effusion, hemothorax, and, particularly with sharp glass foreign bodies, pneumothorax. 6,7,9,15 Documented cases exist where sharp foreign bodies, such as glass shards, 8,11 acupuncture needles, 69,70 and loose Kirschner wires, 71 have gradually migrated into the pleura, ultimately causing the development of hemothorax and pneumothorax. However, there have been cases involving other types of sharp foreign bodies, such as needles, [72][73][74][75] Kirschner wires, [76][77][78] and fixation pins, [79][80][81] which appeared to migrate transthoracically into the lung without causing pneumothorax.…”

Section: Hypothesis Of a Current Impalement Traumamentioning

confidence: 99%

“…In fact, there are at least 7 known cases where relatively large glass shards deep within the body were overlooked. 8,17,18,37,60,[62][63][64] In addition, it is possible that the foreign bodies have undergone significant migration from their original location. The initial entry point and any overlooked scars may have been in a less expected and more peripheral location.…”

Section: Hypothesis Of a Previous Penetrating Traumamentioning

confidence: 99%

“…This minimally invasive approach was also effectively employed in 4 instances immediately after glass impalement 6,7,9,113 and once with an 8-month delay. 8 In other situations, involving intrathoracic glass near critical or complex structures as the heart, major blood vessels, diaphragm, or during emergency situations with limited visibility, an open approach was preferred even in recent years. 11,15,[17][18][19][20] Glass foreign bodies appear to induce minimal fibrotic or adhesive reaction in their surroundings, likely due to their smooth and aseptic surfaces.…”

Section: Treatmentmentioning

confidence: 99%

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Foreign Glass Bodies in Pleura and Pancreas: Systematic Review for Entry Hypotheses and Treatment Options in an Unresolved Case

Ehrsam,

Meier Adamenko,

Schlumpf

et al. 2024

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: Foreign bodies within the pleura and pancreas are infrequent, and the approaches to their treatment still a subject of debate. There is limited knowledge particularly regarding glass foreign bodies. Methods: We present a case involving large glass splinters in the pleura and pancreas, with an unknown entry point. In addition, a systematic review was conducted to explore entry hypotheses and management options. Results: In addition to our case, our review uncovered eight incidents of intrapleural glass, and another eight cases of glass in other intrathoracic areas. The fragments entered the body through impalement (81%), migrated through the diaphragm after impalement (6%), or caused transesophageal perforation (19%) following ingestion. Eight instances of glass inside the abdominal cavity were documented, with seven resulting from impalement injuries and one from transintestinal migration. There were no recorded instances of glass being discovered within the pancreas. Among the 41 nonglass intrapancreatic foreign bodies found, sewing needles (34%) and fish bones (46%) were the most common; following ingestion, they had migrated through either a transgastric or transduodenal perforation. In all these cases, how the foreign bodies were introduced was often poorly recalled by the patient. Many nonglass foreign bodies tend to become encapsulated by fibrous tissue, rendering them inert, though this is less common with glass. Glass has been reported to migrate through various tissues and cavities, sometimes with a significant delay spanning even decades. There are cases of intrapleural migration of glass causing hemothorax, pneumothorax, and heart and major blood vessels injury. For intrapleural glass fragment management, thoracoscopy proved to be effective in 5 reported cases, in addition to our patient. Most intrapancreatic nonglass foreign bodies tend to trigger pancreatitis and abscess formation, necessitating management ranging from laparoscopic procedures to subtotal pancreatectomy. There have been only four documented cases of intrapancreatic needles that remained asymptomatic with conservative management. There is no direct guidance from the existing literature regarding management of intrapancreatic glass foreign bodies. Consequently, our patient is under observation with regular follow-ups and has remained asymptomatic for the past 2 years. Conclusions: Glass foreign bodies in the pleura are rare, and our report of an intrapancreatic glass fragment is the first of its kind. Impalement is the most likely method of introduction. As glass has significant migration and an ensuing complication potential, preventive removal of intrapleural loose glass should be considered. However, intrapancreatic glass fragment management remains uncertain.

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Section: Discussionmentioning

confidence: 99%

Section: Hypothesis Of a Current Impalement Traumamentioning

confidence: 99%

Section: Hypothesis Of a Previous Penetrating Traumamentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

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Foreign Glass Bodies in Pleura and Pancreas: Systematic Review for Entry Hypotheses and Treatment Options in an Unresolved Case

Ehrsam,

Meier Adamenko,

Schlumpf

et al. 2024

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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“…The foreign body may reach its site by a transbronchus, transthoracic, or transdiaphragm route. I conducted an Internet search for “the intrathoracic foreign body, foreign body in lung” for the years 1993–2015 with a Japanese medical central magazine and found 15 cases of intrathoracic foreign body without the patient's awareness in Japan ( Table 1 ) [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] . These cases typically involved adults.…”

Section: Discussionmentioning

confidence: 99%

Accidental chest penetration of glass foreign bodies in a 53 year old lady—The challenges with video assisted thoracoscopic extraction

Shoko

2016

International Journal of Surgery Case Reports

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HighlightsA woman suffered chest injuries from glass without being aware of foreign bodies.We performed urgent video-assisted thoracic surgery to remove the foreign bodies.Preoperatively determining the number of glass pieces by CT is essential.For glass injuries, the possibility of traumatic implantation must be considered.VATS failed to remove the second glass piece and that we converted to thoracotomy.

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