title: Self-inflicted oral penetration injury: An intravenous drip pole advanced from the mouth to the retroperitoneum.
abstract: BACKGROUND
  Patients with oral penetration injuries require a systematic physical examination. These patients should be managed by a multidisciplinary medical team. Airway management, operative procedures, and transfusion needs of the patient with an oral penetration injury should be discussed before surgery.
  
  
  METHODS
  A 63-year-old man with a history of recurrent hepatic duct cancer attempted suicide by advancing an intravenous pole through his mouth, neck, and thorax, ultimately penetrating into the right retroperitoneal space. A multidisciplinary team assembled by code blue emergently treated the patient, initially with fiberoptic intubation. The injured right lower lung was resected under one lung ventilation via a double lumen tube after tracheostomy. Fortunately, the pole did not injure any other organs or major vessels. Despite successful removal of the pole after lung resection, the patient died 14 days postoperatively due to his primary hepatic duct cancer.
  
  
  CONCLUSIONS
  We highlight the need for a multidisciplinary approach to this patient's management and discuss particular aspects of airway and transfusion management.
  
  
  CONCLUSIONS
  A systematic and multidisciplinary approach allowed successful removal of the drip pole and stabilization of the patient's respiratory and hemodynamic status.
authors.affiliation: Yokohama City University Hospital, Department of Anesthesiology and Critical Care Medicine, 3-9 Fukuura, Kanazawaku, Yokohama 236-0004, Japan. Electronic address: shunty5323@gmail.com.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Takaki
authors.affiliation: Yokohama City University Hospital, Department of Anesthesiology and Critical Care Medicine, 3-9 Fukuura, Kanazawaku, Yokohama 236-0004, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Yamaguchi
authors.affiliation: Yokohama City University Hospital, Department of Emergency Medicine, 3-9 Fukuura, Kanazawaku, Yokohama 236-0004, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Morimura
authors.affiliation: Yokohama City University Hospital, Department of Anesthesiology and Critical Care Medicine, 3-9 Fukuura, Kanazawaku, Yokohama 236-0004, Japan.
authors.forename: Takahisa
authors.initials: T
authors.lastname: Goto
keywords: Airway management; Blood transfusion; Intubation; Pneumothorax