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Case Reports
. 2022 May 1:39:100649.
doi: 10.1016/j.tcr.2022.100649. eCollection 2022 Jun.

Penetrating cardiac trauma caused by a nail-gun: A case report and narrative review

A Eranki  1 , A Wilson-Smith  1   2 , C Villanueva  1 , P Seah  1   3
Affiliations
Case Reports

Penetrating cardiac trauma caused by a nail-gun: A case report and narrative review

A Eranki et al. Trauma Case Rep. .

Abstract

Introduction: Penetrating cardiac injuries are emergencies that require prompt surgical management. Most of these injuries are caused by gunshots or stab wounds however the incidence of nail-gun injuries is rising due to their availability and widespread use. Cardiac injuries caused by nail-guns are often self-inflicted. These injuries almost always require operative management with a sternotomy or thoracotomy.

Case report: This case report describes a 47-year-old male with two self-inflicted nail-gun wounds to the chest. He presented in a stable condition and subsequently underwent an emergency sternotomy to repair a penetrating cardiac injury. We highlight our diagnostic and operative approach to this injury and present a contemporary narrative review of similar cases.

Conclusion: Almost all cases of penetrating trauma caused by nail-gun injuries require urgent surgery. Some cases require the use of cardiopulmonary bypass. In this case, the use of the Medtronic® urchin apical suction device, usually reserved for off pump cardiac surgery, facilitated exposure and repair of the lateral wall of the left ventricle.

Keywords: Nailgun; Penetrating cardiac injury; Trauma.

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Conflict of interest statement

No conflicts of interest or financial obligations to disclose.

Figures

Fig. 1
Fig. 1
Location of wounds.
Fig. 2
Fig. 2
Chest-Xray with nails evident.
Fig. 3
Fig. 3
Axial CT (reconstructed window) with nails.
Fig. 4
Fig. 4
Off pump retractor and view of myocardial injury.
Fig. 5
Fig. 5
Bioglue and bovine pericardial patch.
Fig. 6
Fig. 6
Opened left pleura and nail.
See this image and copyright information in PMC

References

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