[Cardiac tamponade due to intrathoracic migration of a Kirschner wire.].
We report a rare case of migration of a Kirschner wire used for fixation of a multifragmentary cervical humerus fracture, causing cardiac tamponade due to main coronary artery and pulmonary injury, transversed the left upper lobe of the lung. We report on a female patient of 65 years of age, admitted to the emergency service following an accidental fall that resulted in a multifragmentary fracture of the neck of the humerus, treated surgically with percutaneous implantation of three Kirschner wires. Six days later the patient complained of chest pain radiating to the arm and back, fatigue, dyspnea and orthopnea, and was readmitted two days later in the emergency department, where chest X-ray revealed the migration of a Kirschner wire into the thoracic cavity and mediastinal widening. An echocardiogram confirmed the diagnosis of pericardial tamponade and the complementary CT scans demonstrated the Kirschner wire in the left pleural cavity.
Serviço de Cirurgia Cardiotorácica do Centro Hospitalar Lisboa Central, Hospital de Santa Marta, Lisboa.
L
L
Baquero
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J
Fragata
D000368:Aged; D001864:Bone Wires / Q000009:adverse effects*; D002305:Cardiac Tamponade / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D002637:Chest Pain / Q000209:etiology; D003331:Coronary Vessels / Q000293:injuries; D004417:Dyspnea / Q000209:etiology; D005260:Female; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000473:pathology*; D005592:Fracture Fixation / Q000295:instrumentation; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery; D055370:Lung Injury / Q000209:etiology*; D035422:Pleural Cavity / Q000473:pathology; D014057:Tomography, X-Ray Computed