title: An unusual case of thoracic impalement injury with severe pleural adhesion.
abstract: Thoracic impalement injury is an uncommon form of trauma. In the present report, we describe the case of a 78-year-old man who was injured by 2 metal rods. We decided to remove the rod on the right side by performing video-assisted thoracic surgery. However, during this procedure, total pleural adhesion was identified. Therefore, a mini-thoracotomy was performed and the rod was removed safely; the patient's postoperative course was uneventful. The rod on the left side did not pass through the thoracic cavity. There are only a few reports of thoracic impalement injury in literature, and cases with total pleural adhesion are very rare. Careful preoperative planning and a multidisciplinary approach are essential for managing this type of injury.
authors.affiliation: Department of Surgery, Tokyo Metropolitan Hiroo General Hospital, Ebisu 2-34-10, Shibuya-ku, Tokyo, 150-0013, Japan, tetsuya_yokosuka@tmhp.jp.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yokosuka
authors.forename: Toshiko
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Michimasa
authors.initials: M
authors.lastname: Fujiogi
authors.forename: Masayo
authors.initials: M
authors.lastname: Kawakami
authors.forename: Masamichi
authors.initials: M
authors.lastname: Yasuno
mesh_terms: D000368:Aged; D006801:Humans; D055370:Lung Injury / Q000209:etiology* / Q000601:surgery; D008297:Male; D010995:Pleural Diseases / Q000209:etiology / Q000601:surgery*; D035423:Thoracic Cavity / Q000601:surgery; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D013908:Thoracotomy / Q000379:methods*; D000267:Tissue Adhesions / Q000209:etiology / Q000601:surgery; D014950:Wounds, Penetrating / Q000209:etiology / Q000601:surgery*
references.citation: Ann Thorac Surg. 2001 Oct;72(4):1364-6
references.pmid: 11603463
references.citation: Eur J Cardiothorac Surg. 2004 Jun;25(6):1048-53
references.pmid: 15145008
references.citation: Ann Thorac Surg. 1988 Jun;45(6):680-1
references.pmid: 3377582
references.citation: Ann Thorac Surg. 1997 Feb;63(2):327-33
references.pmid: 9033295
references.citation: J R Coll Surg Edinb. 1998 Dec;43(6):419-21
references.pmid: 9990795
references.citation: Ann Thorac Surg. 1987 Feb;43(2):189-90
references.pmid: 3813709