Proper Management for Massive Penetrating Chest Trauma Narrowly Missing Major Organs: A Case Report

Chest impalement is a rare type of injury resulting from penetration by a large foreign object that remains in the body. Each case of chest impalement is unique, and the outcome largely depends on the trajectory of the foreign object. Here we present the case of a 48-year-old male who accidentally fell from the rooftop of his house (from a height of several meters), onto a scaffolding tube, which penetrated through the 10th left posterior intercostal space into his chest. Upon transport of the patient to the trauma center, computed tomography (CT) surprisingly revealed no significant damage to the internal organs. The foreign body was successfully removed by left posterolateral thoracotomy, and the postoperative course was uneventful. A good outcome following a chest injury requires timely transport to the trauma center, and multidisciplinary management by an experienced team. In the presented case, the foreign object's trajectory did not cause damage to the internal organs, which was also an important factor contributing to the good outcome.