A case of chest impalement injury with laceration of the axillary artery

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  • 腋窩動脈損傷を伴う胸腔内貫通刺創（杙創）の１例

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Abstract

We report a case of chest impalement injury with laceration of the right axillary artery caused by a wooden foreign body penetrating the right thorax. A 37-year-old male fell off a bicycle, and received suture treatment of the right upper arm for a contused wound. Two weeks later, the patient showed hemorrhaging while undergoing suture removal, and was transferred and admitted to our hospital. Chest computed tomography showed fluid collection in the right thorax, and we performed chest drainage with a diagnosis of hemothorax due to rib fracture and pulmonary contusion. As a result, thoracic surgery was performed because of poor drainage. The right thorax was filled with an infectious hematoma, and a wooden foreign body penetrating through the right upper arm wound was discovered. The bleeding point was identified as a laceration of the right axillary artery. The operative methods were removal of the hematoma, decortication, resection of the pleural callosity, and direct suture of the right axillary artery. Postoperatively, the patient still showed fistula-related empyema requiring two other operations and bronchial occlusion on bronchoscopy. The patient has been successfully rehabilitated.

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