title: [High-age thoracic impalement injury treated by conservative therapy].
abstract: Thoracic impalement injury is uncommon mechanism of injury. We describe a case treated successfully by non-surgical management. An 87-year-old male got impalement injury in his room by a part of stepladder on right anterior chest wall. He was found to be alert and hemodynamically stable, so computed tomography (CT) scan was performed. Chest CT showed right-sided hemopneumothorax and pulmonary contusion, but no cardiac and great vessels injury. We discussed about performing video-assisted thoracic surgery (VATS), but selected non-surgical treatment including chest drainage at that time, because of low possibilities of massive bleeding and apprehension of postoperative complication resulting from patient's high age. He had uneventful recovery and was discharged on foot 13 days after admission.
authors.affiliation: Department of Emergency Care Center and Surgery, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yokosuka
authors.forename: Makoto
authors.initials: M
authors.lastname: Mitsusada
authors.forename: Takeyuki
authors.initials: T
authors.lastname: Aoki
authors.forename: Toshiko
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Shirokawa
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Nakajima
mesh_terms: D000061:Accidents, Home; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D013898:Thoracic Injuries / Q000175:diagnosis / Q000628:therapy*; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000628:therapy*