Accidental neck and chest penetration by a metal sliver derived from an axe for wood chopping: a case report

Abstract

Background Penetrating neck and chest trauma is a very common entity in emergency medicine that usually requires surgical treatment. Our case report illustrates the case of a 27-year-old Arabian man with hemopneumothorax associated with pneumomediastinum due to an unusual occupational injury. Case presentation A metal sliver, coming from an axe using for wood chopping, penetrated the neck of a 27-year-old Arabian man in the left supraclavicular region mimicking a gun bullet; the entrance hole was at the left pleural dome where the sliver had just penetrated the apex of the lung passing through the upper lobe of his left lung creating an exit wound in the dorsal segment of the same lobe arriving in the posterior thoracic wall. Biportal video-assisted thoracic surgery was performed to remove blood clots and the unusual foreign body. Conclusion In the literature, there are several case series about this topic, with some of them reporting unusual foreign bodies that lead to penetrating trauma. However, to the best of our knowledge, no cases like the one we have reported are described in the current literature.

An Unusual Cervical Penetrating Wound Extended to the Right Pleural Dome

“…In the present study, the reason for consultation was the knife implanted in the neck. This is one of the main reasons for penetrating cervical wounds after attempted suicide [11] [20] [22]. Other reasons reported by the authors were hemoptysis and dyspnea [7] [23].…”

A case report of cervicothoracic penetrating injury with retention of foreign body

“…The ideal incision should allow adequate exposure of the injury area with the ability to extend the incision if necessary [ 7 ]. As for penetrating trauma, immediate life-saving measures, rapid transfer to a tertiary trauma center, appropriate intensive care, a series of reassessed targeted examinations in the emergency room, timely diagnosis, and surgical intervention by multidisciplinary teams are necessary procedures [ 8 ]. It is also crucial for the successful treatment of the patient to formulate diagnosis and treatment plans in detail before, during, and after operation.…”