Thoracic foreign body management after penetrating chest trauma by chainsaw in the Amazon countryside: A case report

• Published in: Annals of medicine and surgery (2012) 2021, Vol.72, p.103101-103101
• Main Authors: Fontelles, João Lucas Miranda, da Silva Júnior, Messias Froes, Rodriguez, Juan Eduardo Rios, Regino, Hafiza Gonçalves Alexandrino, Lopez, Estevan Criales, Cauduro, Júlia Fialho, Froes, Héria Terezinha Rodrigues Brito, Cattebeke, Tatiana Minda Herculano, Menezes, Arteiro Queiroz
• Format: Report
• Language: English
• ISSN: 2049-0801; 2049-0801
• DOI: 10.1016/j.amsu.2021.103101

INTRODUCTIONAccidents involving chainsaws are not uncommon in trauma care and may present as penetrating injuries with retention of a foreign object in the patient's chest. The current literature, however, does not present a consensus on the best way to approach these cases. PRESENTATION OF CASEMale patient, 46-year-old man, born in Amazonas countryside, brought to the city of Manaus with a penetrating injury resulting from an accident with a chainsaw and retaining a 2cm sawtooth in his chest, six days after the event. After laboratory and imaging tests, as well as pre-operative preparation, an open thoracotomy was realized, the object was removed, and the patient was placed under a thoracostomy tube. DISCUSSIONThe diagnosis of chainsaw incidents is generally described in the literature as post-mortem, mainly due to the inappropriate use of the equipment. Surgical removal of a foreign body is indicated in most cases, except when it is peripheral or when there is some impossibility. Early surgical treatment benefits the patient, with lower mortality and morbidity. CONCLUSIONIn view of the absence of consensus and guidelines to the approach of thoracic injury with foreign body retention, it is up to the surgeon to evaluate the best conduct in each case and according to the available resources.