Trauma Case Reports (Dec 2023)

A rare case of perforating chest wall including pericardial sac with penetrating trivial injury: A case report and literature review

  • Venkata Sai Harshabhargav Chenna,
  • Lokeshwar Raaju Addi Palle,
  • Sanni Emmanuel,
  • Ayushman Gupta,
  • Deepa Treesa Francis,
  • Akbar Hussain,
  • Rojaj Dahal,
  • Carlo Kristian Chu Carredo,
  • Sandra Mary Francis,
  • Tulika Garg,
  • Ogbonnaya Akuma,
  • Aadil M. Khan

Journal volume & issue
Vol. 48
p. 100962

Abstract

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Perforating chest wall injuries involving the pericardial sac in pediatric patients are exceedingly rare and pose a unique clinical challenge. Thoracic trauma in the pediatric population remains a significant cause of morbidity and mortality. We present a case of an 8-year-old boy with an acute history of a sharp injection needle embedded in his chest wall presented with severe chest pain and diaphoresis. Diagnostic evaluations included computed tomography revealed a hyperdense focus with a metallic artefact seen impacted in the interventricular septa and perforating the heart. He underwent a thoracotomy and cardioplegic arrest for needle retrieval and subsequent cardiac repair. Our case underscores the importance of a multidisciplinary approach, meticulous monitoring, and a profound understanding of the unique anatomical considerations in pediatric chest injuries. Summary: This article presents a rare and challenging case of an 8-year-old male who arrived at the emergency department with a sharp injection needle embedded in his chest wall. Despite being relatively rare in children, thoracic injuries can be severe and potentially life-threatening. A fast and accurate diagnostic approach is crucial to prevent fatal complications. Thoracic trauma in the pediatric population remains a significant cause of morbidity and mortality. Timely diagnosis and appropriate interventions are critical in improving patient outcomes. The presented case highlights the need for caution and a well-planned approach in managing such rare and complex injuries in children.

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