Pulmonary Tractotomy for a Penetrating Lung Injury Caused by a Metal Fragment—Report of a Case—

Abstract

Chest injuries are classified into penetrating and blunt trauma. In Japan, penetrating thoracic trauma is infrequent, accounting for approximately 15% of all chest traumas. Most penetrating lung injuries do not require thoracotomy and are treated with a thoracic drain. We have experienced a case in which pulmonary tractotomy was useful for penetrating lung injury and a foreign body in the lung. A 30-year-old man had been operating an industrial press machine when a piece of metal flew out of it and embedded in the left thorax. Chest X-ray and CT scans revealed that metal fragments were retained in the lingular segment of the left lung and confirmed the diagnosis of penetrating lung injury due to a foreign body. A thoracotomy was performed to identify and treat the injury as well as to remove the foreign body. The entry hole of the metal piece was found in the upper left lobe, and a hard foreign body was palpable in the lingular segment. Stapled pulmonary tractotomy was successfully performed to ensure hemostasis and remove the foreign body. The patient had a good postoperative course and was discharged from our hospital without any complications on the 23 rd POD. Our experience suggests that pulmonary tractotomy is a useful technique for penetrating lung injury caused by a metal fragment.