Long Standing Retained Knife Blade after Stabbing to the Chest

Celestin Danwang, Adele Tatiana Abo’o Melom, Jean Claude Mballa, Eric MagnyTiam, Jean Jacques Ze, Atems Nkolata, Bernadette Ngo Nonga

Abstract


RÉSUMÉ
Background.Retained knife blade after a chest injury is a rare condition which can cause many complications with regards to important anatomical structures situated in the chest, particularly the mediastinum and the possibility of migration of the retained foreign body. As at now,only few cases have been reported in literature. Case presentation. We report the case of a 38-year old male Cameroonian, with no significant past medical history, referred to our out-patient department, for left shoulder pain following a penetrating chest injury seven weeks prior to the consultation. An intra-thoracic metallic foreign body resulting from a neglected penetrating chest injury was diagnosed. A chest CT scan permitted the precision of the foreign body with respect to internal chest structures. With the aide of this precision, under local anesthesia, the foreign body was then removed successfully. The patient was discharged after a period of three uneventful postoperative days and three control chest X-rays revealing no complications. Conclusion. Physical examination following a penetrating chest injury may not be sufficient to diagnose a chest foreign body. Therefore, a high index of suspicion should be kept for cases presenting with a penetrating chest injury, with emphasis on clinical examination, the mechanism of injury; supported by a chest X-ray and/or CT-scan when available.

ABSTRACT
Background. L’impaction d‘un couteau après une plaie thoracique pénétrante peut entrainer de grave conséquences causes des structures vitales se trouvant au niveau de la poitrine, surtout au niveau du médiastin ou le corps étranger peut même parfois migrer ailleurs. Très peu de cas ont rapportés dans la littérature à ce sujet. Cas clinique. Nous rapportons le cas d’un jeune homme de 38 ans sans antécédents particuliers qui a été référé pour douleur à l’épaule gauche après une plaie par arme blanche 7 semaines auparavant. Un corps étranger métallique intra thoracique a été démontré par les examens diagnostiques. La tomodensitométrie a permis de localiser la lame et a démontré que les structures vasculaires du médiastin étaient intactes. Cette précision anatomique nous a aidés à enlever le morceau de lame avec susses .Le patient est sorti de l’hôpital au 3ème jour postopératoire. La radiographie de control était sans particularités. Conclusion. L’examen clinique peut ne pas être suffisant après une plaie pénétrante et un bilan radiologique être très utile. Une importance particulière doit être accordée à la recherche des complications et il ne faut pas hésiter à demander des bilans radiologiques.

Keywords


Chest trauma; foreign body; Cameroon; retained knife blade, stab wound

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References


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