Citation

Yoo B, Shin YC. Int. J. Surg. Case Rep. 2019; 66: 174-177.

Affiliation

Department of Thoracic and Cardiovascular Surgery, Inje University Ilsan Paik Hospital, Republic of Korea. Electronic address: cheolkweon@daum.net.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.ijscr.2019.12.006

PMID

31862661

Abstract

INTRODUCTION: Penetrating cardiac injury often occurs in South Korea. However, impalement injury of the heart with other organs is rare and fatal. We present a case of cardiac impalement injury by a steel rebar. PRESENTATION OF CASE: A 38-year-old man was brought to the emergency room with a steel rebar of 45.5 cm in length in situ. Chest tomography revealed that the rebar had entered the thorax to the right diaphragm via the left shoulder while piercing the heart. The patient was immediately taken to the operating room for surgery without removing the bar. We were able to rescue the patient with an emergency operation wherein the bleeding site was treated by pulling the steel rebar out step-by-step while performing cardiopulmonary bypass.

DISCUSSION: Early diagnosis and rapid surgery are important factors for patients with cardiac impalement injury. Haemostasis must be achieved patiently step- by- step without removing the foreign object at once. CPB is an appropriate treatment, even if there is a risk of bleeding.

CONCLUSION: This case highlights the importance of immediate surgical treatment for the survival of severe thoracic impalemant injury patients.

Copyright © 2019 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Language: en

Keywords

Cardiac injury; Computed tomography; Impalement; Steel rebar