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. 2009 Jun;43(2):86-9.
doi: 10.4314/gmj.v43i2.55320.

Impalement injuries of the chest

F Edwin  1 , M Tettey, L Sereboe, E Aniteye, D Kotei, M Tamatey, K Entsuamensah, I Delia, K Frimpong-Boateng
Affiliations

Impalement injuries of the chest

F Edwin et al. Ghana Med J. 2009 Jun.

Abstract

Impalement injuries of the chest are uncommon in civilian practice with few reports in the literature. We report three cases of thoracic impalement seen over a 5 year period with unusual underlying mechanisms. In two of the cases, the impalement was obvious; in the third, the impalement was concealed having occurred 5 months earlier. In Case 1, the underlying mechanism was a high-speed road traffic accident. The patient was impaled by a metallic square pipe piled by the roadside. In Case 2, the gun-housing of a locally-made rifle gave way as it was fired and allowed a reverse ejection of the barrel during recoil that impaled the hunter's chest. In Case 3, a domestic assault with an old umbrella caused an impalement injury as one of the umbrella spokes broke off, penetrated and lodged in the left chest going unnoticed for 5 months. Persistent chest pain and haemoptysis led to a request for chest radiographic examination upon which the foreign body was discovered. Massive haemoptysis brought the patient to emergency thoracotomy. All three patients underwent thoracotomy with a successful outcome.

Keywords: Impalement injuries; debridement; management; mechanisms; thoracic.

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Figures

Figure 1
Figure 1
Case 1 with impaled metallic object
Figure 2
Figure 2
Case 2: The gun barrel protruding from the suprasternal notch.
Figure 3
Figure 3
Case 3: Chest X-ray showing left pleural effusion (haemorrhagic). The umbrella spoke is seen in the left upper hemithorax.
See this image and copyright information in PMC

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