Impaled Metallic Rod- a Serious Threat to a Child’s Life

Penetrating chest wall injuries are life threatening necessitating prompt surgical management. Impaled foreign body in thorax requires major intervention and removal under direct vision. We report a 14 year old boy presenting to emergency department with impaled metallic foreign body to the posterior chest wall. He was anxious, however stable clinically. On examination, foreign body was found penetrating the left 7th intercostal space 2 cm away from midspinal line. Chest x-ray showed radiopaque sharp object within left hemithorax. After blood products were arranged, general anesthesia was given without manipulation of foreign body. Posterolateral thoracotomy was done one intercostal space above injury, metallic rod was found penetrating lung one centimeter from thoracic aorta. It was removed under vision, intercostal bleeder was ligated, lacerated lung repaired. Chest cavity was thoroughly irrigated, no cerebrospinal fluid leak was observed. Patient was extubated on table and shifted to ward. No neurological deficit was identified and the patient was discharged on third post-operative.