ArticleInternational journal of surgery case reports2025
Successful management of left-sided thoracic impalement in a resource-limited setting: A case report.
Article in International journal of surgery case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThoracic impalement injuries are rare and life-threatening. Managing them in resource-limited settings poses significant challenges. CASE PRESENTATION: A 63-year-old male fell 3 m from a tree, sustaining a left-sided chest impalement at the 7th intercostal space along the mid-axillary line. On arrival, his vitals were BP 100/70 mmHg, pulse 104 bpm, RR 32/min, and SpO₂ 78 % (improving to 90 % with oxygen). Examination revealed absent air entry on the left, a sucking chest wound, and an impaled wooden fragment. Initial management included resuscitation, antibiotics, and tetanus prophylaxis. A left anterolateral thoracotomy revealed 7th and 8th rib fractures, lung damage, and an embedded wooden object, which was removed with wedge resection and chest tube placement. The patient had an uneventful recovery and was discharged in stable condition. DISCUSSION: Thoracic impalement injuries pose significant challenges due to the risk of severe hemorrhage, infection, and organ damage. Left-sided injuries are particularly critical due to proximity to the heart and great vessels. Avoiding premature removal of the foreign object, prioritizing hemodynamic stabilization, and expediting surgical intervention are key principles in management.
conclusionTimely intervention, controlled foreign body removal, and adherence to trauma protocols are essential for successful management of thoracic impalement injuries, even in resource-limited settings.
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