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Mediastinal impalement with a fibreglass sheet.
Welege Samantha Buddhika Wimalachandra, Atasha Asmat1
1Division of Thoracic Surgery, Department of General Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433. atasha_asmat@ttsh.com.sg.
Singapore Medical Journal
|October 3, 2014
Summary
Mediastinal impalement is rare and often fatal. This case highlights successful surgical removal of a fiberglass impalement from the anterior mediastinum, demonstrating patient survival.
Area of Science:
- Trauma Surgery
- Thoracic Surgery
- Emergency Medicine
Background:
- Mediastinal impalement injuries are infrequent and carry a high mortality rate.
- Survival is exceptionally rare, with most patients requiring immediate surgical intervention.
- Standard management involves operative exploration irrespective of hemodynamic stability or comorbidities.
Observation:
- A patient sustained a mediastinal impalement injury from a fractured fiberglass sheet.
- The impalement involved the anterior mediastinum and fractured the manubrium.
- Crucially, there were no associated injuries to the great vessels.
Findings:
- Surgical removal of the fiberglass impalement was successfully performed.
- A partial sternotomy approach facilitated the removal.
- The patient experienced an uncomplicated postoperative recovery.
Implications:
- This case demonstrates the potential for survival in severe mediastinal impalement injuries.
- Early surgical intervention, even in complex cases, can lead to favorable outcomes.
- Highlights the importance of prompt diagnosis and management in thoracic trauma.