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Case Reports
. 2017 Jan 10;9(1):e971.
doi: 10.7759/cureus.971.

Self-inflicted Cardiac Injury with Nail Gun Without Hemodynamic Compromise: A Case Report

Simon Ho  1 , Bo Liu  2 , Nicholas Feranec  3
Affiliations
Case Reports

Self-inflicted Cardiac Injury with Nail Gun Without Hemodynamic Compromise: A Case Report

Simon Ho et al. Cureus. .

Abstract

Pneumatically powered nail guns have been used in construction since 1959. Penetrating injuries to the heart with nail guns have a wide range of presentations from asymptomatic to cardiac tamponade and exsanguination. Mortality related to cardiac nail gun injuries is similar to knife injuries, estimated at 25%. Surgical exploration is the treatment of choice. We describe a case of self-inflicted nail gun injury to the chest without hemodynamic compromise in a 51-year-old man. Computed tomography (CT) imaging confirmed nail penetrating the right ventricle, with the tip adjacent to but not violating the abdominal aorta. The patient was successfully treated with thoracotomy and foreign body removal.

Keywords: cardiothoracic surgery; computed tomography; nail gun; penetrating chest injury; trauma.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Anteroposterior Chest X-Ray
Anteroposterior chest X-ray showing metallic nail overlying the heart (arrows). Also seen are buckshot overlying the left lateral chest wall and a healed left lateral rib fracture associated with a prior injury.
Figure 2
Figure 2. Lateral Chest X-Ray
Lateral chest X-ray confirming the nail is indeed inside the thorax (arrows).
Figure 3
Figure 3. Axial contrast-enhanced computed tomography (CT)
Axial contrast-enhanced computed tomography (CT) image of the abdomen showing nail tip adjacent to the abdominal aorta (arrow).
Figure 4
Figure 4. Sagittal reformatted contrast-enhanced CT
Sagittal reformatted contrast-enhanced CT image showing longitudinal plane of the nail with the tip as previously described and the tail in the posterior wall of the right ventricle (arrows).
Figure 5
Figure 5. Right lateral 3D constructed contrast-enhanced CT
Right lateral 3D constructed contrast-enhanced CT image showing presence of the nail puncturing the heart with the tip lying adjacent to the abdominal aorta (arrows), without evidence of rupture.
See this image and copyright information in PMC

References

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