A knife blade retained in the axillary hole
Keywords:
axilla, trauma, puncture wounds, retained foreign body, chest trauma.Abstract
Introduction: The finding of a retained foreign body, specifically a knife blade, is a rare event. Sometimes these foreign bodies go unnoticed and are diagnosed deferred or delayed.Objective: To describe the diagnosis and treatment of a patient with a knife blade retained on axillary hole.
Clinical case: 25-year-old male, attacked with a knife, who suffered a wound in the posterior region of the shoulder and was sutured without performing any complementary examination. Two weeks later, he came due to discomfort from the injured shoulder. An X-ray of the shoulder was indicated, where a radiopaque image appeared that corresponds to the knife blade, in subscapular projection. He refers shoulder discomfort and functional impotence. It is operated under general anesthesia, axillary incision, the object is identified in intimate contact with the axillary vein, the tip towards the axillary vertex, crossing under the axillary vein at its entrance to the thorax, the foreign body is removed under direct vision and without complications. Evolved favorably.
Conclusions: Retained foreign bodies that go unnoticed are rare. However, there are regions such as the armpit where, due to the anatomical characteristics of the space, their diagnosis is difficult. In this case, an unusual combination of phenomena coincided, the defensive attitude of the injured person and the direction of the lunge, which led to the blade remaining in the axillary hole.
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References
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2. Apiliogullari B, Duzgun N, Kurtipek E, Esme H. Retained foreign body after chest stab wound. BMJ case reports. 2014; 2014. DOI: 10.1136/bcr-2014-203598
3. Sobnach S, Nicol A, Nathire H, Kahn D, Navsaria P. Management of the retained knife blade. World journal of surgery. 2010; 34(7):1648-52. DOI: 10.1007/s00268-010-0514-4
4. Kodadek LM, Leeper WR, Caplan JM, Molina C, Stevens KA, Colby GP. Retained transcranial knife blade with transection of the internal carotid artery treated by staged endovascular and surgical therapy: technical case report. Neurosurgery. 2015; 11(Suppl. 2): E372-5. DOI: 10.1227/NEU.0000000000000691
5. Mouaffak Y, Elfadel B, Boutbaoucht M, El Adib AG, Younous S, Aderdour L, et al. A case of penetrating axillary trauma. Revue de stomatologie et de chirurgie maxillo-faciale. 2011; 112(6):369-71. DOI: 10.1016/j.stomax.2011.08.002
6. Herrera MA, Millan M, Del Valle AM, Betancourt-Cajiao M, Caicedo Y, Caicedo I, et al. Damage control of peripheral vascular trauma - Don't be afraid of axillary or popliteal fosses. Colombia Med. 2021; 52(2):e4074735. DOI: 10.25100/cm.v52i2.4805
7. Ndong A, Ba PO. Delayed diagnosis of foreign body in the chest wall after trauma: a case study. The Pan African Medical Journal. 2018; 31:242. DOI: 10.11604/pamj.2018.31.242.17622
Published
2023-01-01
How to Cite
1.
Fando Couso E, Reyes de la Paz A, Valle Lara Y, Aparicio Cáceres J. A knife blade retained in the axillary hole. Rev Cubana Med Milit [Internet]. 2023 Jan. 1 [cited 2025 Apr. 2];52(1):e02302056. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/2056
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