A Case of Penetrating Thoracic Trauma due to Broken Metal Pieces

Abstract

The case involved a 46-year-old man who had sustained injuries to the chest due to scattered pieces of hard metal which composed the press machine and contacted with copper products ; the hard metal had broken for a load resulting from malfunction during he pressed the products. He visited a neighboring hospital and was confirmed to have foreign bodies of metal concentration in the right thoracic cavity. After a thoracic drain was placed for right hemopneumothorax, he was brought into our hospital. Emergency operation was performed with diagnoses of right traumatic hemopneumothorax, foreign bodies in the right lung, and right lung contusion (penetrating trauma). A right side forth intercostal thoracotomy was made with a 6.5-cm long right axillary incision, and video-assisted thoracoscopic surgery was performed. Massive hematoma was confirmed, and a total of 1600g of hematoma and blood in the right thoracic cavity was removed. A metal piece was found at a portion where was the exit of the lung laceration which was made by the metal piece passing through the upper lobe of the right lung after it penetrated to the right thoracic cavity from the right subclavian second intercostal space. We performed partial resection of the upper lobe of the right lung by intending to shape a surgical area so as to involve the penetrating trauma entirely. No blood transfusion was done. The thoracic drain was removed on the 3^rd postoperative day and he was discharged from our hospital without particular complications on the 11^th POD.
We present this successful emergency surgery for a thoracic trauma caused by a broken metal piece which had penetrated from the chest wall to the lung, which is rare.