title: Impacted thoracic foreign bodies after penetrating chest trauma.
abstract: BACKGROUND
  Retained foreign bodies in the chest may include shell fragments, bullets, shrapnel, pieces of clothing, bones, and rib fragments. The risks of removal of foreign bodies must be weighed against the complications of leaving them inside the chest.
  
  
  METHODS
  We treated 90 cases of retained intrathoracic foreign bodies in patients admitted to 3 tertiary centers in Saudi Arabia between March 2015 and March 2016. Sixty patients were injured by shrapnel, 26 had one or more bullets, 3 had broken rib fragments, and one had a metal screw. The chest wall was site of impaction in 48 cases, the lungs in 24, pleura in 14, and mediastinum in 4.
  
  
  RESULTS
  Removal of the retained foreign body was carried out in 12 patients only: bullets in 9 cases, bone fragments in 2, and a metal screw in one. The predictors for removal were bullets, female sex, and mediastinal position with bilateral chest injury, especially with fracture ribs.
  
  
  CONCLUSIONS
  Retained intrathoracic foreign bodies due to penetrating chest trauma are treated mainly conservatively unless there is another indication for chest exploration.
authors.affiliation: Cardiothoracic Surgery Department, Mansoura University Hospitals, Egypt Sameh001@yahoo.com.|Thoracic Surgery Department, King Abdullah Medical City, Makkah, Saudi Arabia.
authors.forename: Sameh I
authors.initials: SI
authors.lastname: Sersar
authors.affiliation: Cardiothoracic Surgery Department, King Fahd Central Hospital, Jizan, Saudi Arabia.
authors.forename: Khalid A
authors.initials: KA
authors.lastname: Albohiri
authors.affiliation: Cardiothoracic Surgery Department, Mansoura University Hospitals, Egypt.|Cardiothoracic Surgery Department, King Khalid Hospital, Najran, Saudi Arabia.
authors.forename: Hysam
authors.initials: H
authors.lastname: Abdelmohty
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005547:Foreign Bodies / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012253:Rib Fractures / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D018570:Risk Assessment; D012307:Risk Factors; D012529:Saudi Arabia; D012737:Sex Factors; D062606:Tertiary Care Centers; D013898:Thoracic Injuries / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D019616:Thoracic Surgical Procedures / Q000009:adverse effects; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D055815:Young Adult
keywords: Drainage; Lung injury; Thoracic injuries; Thoracotomy; Wounds; gunshot; penetrating