Penetrating Cardiac Nail Gun Injury in a Child (original) (raw)
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Penetrating cardiac and great vessels trauma is life threatening and a surgical challenge. We relate an unusual case of pulmonary artery injury secondary to an accidental trauma by a nail gun. Surgical repair was late but successful.
Cardiac pneumatic nail gun injury
The Journal of Thoracic and Cardiovascular Surgery, 2006
able. This strategy is useful to experienced VATS surgeons dealing with difficult cases, as well as to beginner VATS surgeons learning complex VATS procedures. We believe this approach may lead to wider acceptance of VATS major pulmonary resection among the thoracic surgical community. References 1. Yim APC. Minimizing chest wall trauma in video assisted thoracic surgery.
A unique nail gun injury to the heart with a delayed presentation
Interactive CardioVascular and Thoracic Surgery, 2011
We describe a 24-year-old construction worker who was unaware that he had been shot by a pneumatic nail gun in the chest during work. After returning home, he felt some palpitations and mild shortness of breath, and in the mirror discovered a non-bleeding pinpoint skin wound in his upper chest. He admitted himself to the emergency department of a local hospital and, after a detailed history and a chest X-ray had been taken, he was surprisingly diagnosed with a penetrating nail injury to the heart and was referred to our center. Transthoracic echocardiography and chest computed tomography were done, and the patient was transported to the operating room. After the nail had been removed and the mitral valve repaired, the patient was discharged on the fifth postoperative day without any complications.
International Journal of Surgery Case Reports, 2016
INTRODUCTION: Work site injuries involving high projectile tools such as nail guns can lead to catastrophic injuries. Generally, penetrating cardiac injuries are associated with a high mortality rate. PRESENTATION OF CASE: A construction worker was brought to the emergency room having sustained a nail gun injury to the chest. The patient was hypotensive, tachycardic with prominent jugular venous distention, and had a profound lactic acidosis. Bedside ultrasound confirmed the presence of pericardial fluid. Pericardiocentesis was performed twice using a central venous catheter inserted into the pericardial space, resulting in improvement in the patient's hemodynamics. Thereafter he underwent left anterolateral thoracotomy and repair of a right atrial laceration. He recovered uneventfully. DISCUSSION: Penetrating cardiac injuries caused by nail guns, although rare, have been previously described. However, pericardiocentesis, while retaining a role in the management of medical causes of cardiac tamponade, has been reported only sporadically in the setting of trauma. We report a rare case of penetrating nail gun injury to the heart where pericardiocentesis was used as a temporizing measure to stabilize the patient in preparation for definitive but timely operative intervention. CONCLUSION: We propose awareness that percardiocentesis can serve as a temporary life saving measure in the setting of trauma, particularly as a bridge to definitive therapy. To our knowledge, this represents the first reported case of catheter pericardiocentesis used to stabilize a patient until definitive repair of a penetrating cardiac injury caused by a nail gun.
Nail gun penetrating injury of the heart mimicking an acute coronary syndrome
International Journal of Emergency Medicine, 2010
We describe the case of a 75-year-old man admitted to hospital for chest pain and syncope. Physical examination was normal with evidence of a very small wound on the left chest. Considering the presence of multiple coronary risk factors, an acute coronary syndrome was initially suspected, but the electrocardiogram (EKG) was normal and only a slight increase of cardiac enzymes was detected. The hypothesis of aortic dissection was also considered and in order to discriminate between the aortic and coronary syndrome, a thoracic and coronary computed tomography (CT) scan was performed. The CT scan showed a metallic structure, suggestive of a nail, about 6 cm in length, in the deep layers of the left ventricular wall and a small pneumothorax due to a lung lesion. The patient was therefore transferred to our department for urgent cardiac surgery that was performed without complications.
Role of chest CT scan in atypical cardiac trauma management: Left ventricle injury by a nail gun
Radiology Case Reports, 2021
We report a case of an accidental penetrating cardiac trauma with a nail gun. A 28-year-old man was repairing a sofa with a nail gun when a nail was misfired to his chest. At the time of his presentation, he underwent chest CT scan, showing the nail as a sharp hyperdense foreign body penetrating the chest wall passing through the lower lobe of the left lung and finally the anterior aspect of left ventricle cavity. This report highlights the utility of the chest CT scan to detect trajectory of the misfired nail accurately and instantaneously in a hemodynamically stable patient to assist in the surgery plan.
Serious injury and fatality investigations involving pneumatic nail guns, 1985-2012
American journal of industrial medicine, 2016
This article examines serious and fatal pneumatic nail gun (PNG) injury investigations for workplace, tool design, and human factors relevant to causation and resulting OS&H authorities' responses in terms of citations and penalties. The U.S. Occupational Safety and Health Administration (OSHA) database of Fatality and Catastrophe Investigation Summaries (F&CIS) were reviewed (1985-2012) to identify n = 258 PNG accidents. 79.8% of investigations, and 100% of fatalities, occurred in the construction industry. Between 53-71% of injuries appear to have been preventable had a safer sequential trigger tool been used. Citations and monetary penalties were related to injury severity, body part injured, disabling of safety devices, and insufficient personal protective equipment (PPE). Differences may exist between construction and other industries in investigators interpretations of PNG injury causation and resulting citations/penalties. Violations of PPE standards were penalized most s...