2024 Volume 38 Issue 6 Pages 567-571
Needles that penetrate the human body may migrate, causing late complications leading to organ injury. Penetrating chest injury with a needle is rare. Here, we report a case of late-onset post-traumatic pneumothorax caused by a foreign metallic body (a metal wire from a brush) that occasionally penetrated the skin. A 31-year-old man presented to our hospital with chest discomfort. He sometimes felt pain due to a broken piece of wire brush piercing the skin of the anterior chest through his clothing while removing surface paint. Chest computed tomography revealed a right pneumothorax with a foreign body embedded in the first intercostal space of the right thoracic cavity, piercing the chest wall. Traumatic pneumothorax was diagnosed, suggestive of a metallic needle as the cause. Thoracoscopy revealed a metallic needle penetrating the right anterior chest wall. Under chest fluoroscopy guidance, the 2-cm metallic needle was completely removed. Air leakage was not observed on damaged pleural surfaces. Thoracoscopic surgery with chest fluoroscopic assistance was useful for the detection and complete removal of the foreign body. Considering the potential lethality such as greater vessel injury in the anterior mediastinum, early surgical intervention is necessary once a foreign metallic body penetrates the anterior chest wall.
