Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2020; 8(20): 5025-5029
Published online Oct 26, 2020. doi: 10.12998/wjcc.v8.i20.5025
Chest, pericardium, abdomen, and thigh penetrating injury by a steel rebar: A case report
Xian-Wei Yang, Wen-Tao Wang
Xian-Wei Yang, Wen-Tao Wang, Department of Liver Surgery & Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu 610000, Sichuan Province, China
Author contributions: Yang XW wrote the manuscript; Yang XW and Wang WT managed the patient; Yang XW and Wang WT prepared the images; all authors approved the final version.
Supported by the Science and Technology Program of Sichuan Science and Technology Department, Nos. 2019YFS0029 and 2019YFS0529; the National Natural Science Foundation of China, No. 81770566.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016)
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Wen-Tao Wang, MD, PhD, Full Professor, Surgeon, Department of Liver Surgery & Liver Transplantation Center, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu 610000, Sichuan Province, China. wwtdoctor03@163.com
Received: August 11, 2020
Peer-review started: August 11, 2020
First decision: August 21, 2020
Revised: August 22, 2020
Accepted: September 10, 2020
Article in press: September 10, 2020
Published online: October 26, 2020
Abstract
BACKGROUND

Combined penetrating trauma involving the chest, pericardium, abdomen, and thigh is rare and lethal. It is difficult to quickly rescue patients with penetrating injuries from long steel bars.

CASE SUMMARY

A previously healthy 56-year-old male worker presented with a length of rebar that penetrated the chest-abdomen-pelvic cavity and was palpable on the anterior side of the neck and thigh. On radiological imaging, the left chest wall-left chest cavity-mediastinum-abdominal cavity-right groin area-right thigh demonstrated a strip-like density shadow, about 1.5 cm thick, with the heart, stomach wall, and part of the intestine involved. There was a left-sided pleural effusion, left lung compression of about 50%-60%, and a small amount of left pleural effusion/blood accumulation; possible perforation of hollow organs; and double multiple ribs fractures on the side. An emergency green channel was opened to provide a rescue process for smooth and timely diagnostic and treatment to save the patient's life. The patient was followed at 4 mo after discharge and showed good recovery.

CONCLUSION

For pre-hospital emergency treatment in locations that are not fully prepared for surgery, we do not recommend cutting the steel bars outside the body. We advocate pulling out foreign bodies intact to reduce secondary injuries.

Keywords: Penetrating trauma, Rebar, Diaphragm injury, Thoracoabdominal, Pre-hospital emergency, Case report

Core Tip: Rebar penetration injury is extremely rare, but it is life-threatening for construction workers, especially chest, abdomen, pelvic cavity, and limb injuries. The length, diameter, and path into the human body are the main factors that affect pre-hospital emergency and surgical methods. We do not recommend cutting the steel bars outside the body. We advocate pulling out foreign bodies as a whole to reduce secondary injuries. At the same time, post-traumatic management is also critical.