Accidental chest penetration of glass foreign bodies in a 53 year old lady—The challenges with video assisted thoracoscopic extraction

• A woman suffered chest injuries from glass without being aware of foreign bodies.
• We performed urgent video-assisted thoracic surgery to remove the foreign bodies.
• Preoperatively determining the number of glass pieces by CT is essential.
• For glass injuries, the possibility of traumatic implantation must be considered.
• VATS failed to remove the second glass piece and that we converted to thoracotomy.

IntroductionIn rare cases, a foreign body may penetrate the thoracic cavity without the person’s awareness. I report a case of the traumatic intrathoracic foreign body of glass implants that the patient did not have awareness about.Presentation of caseThe 53-year-old woman was unsteady on her foot and leaned against the sliding door of the glass in a washroom. She fell unto a crashing glass panel sustained chest injury, and then she noticed bleeding from the left chest. Dyspnea and chest pain were emergent gradually. Chest Computed Tomography (CT) showed two foreign bodies which she did not complain of in a left pleural cavity. We performed an emergency video-assisted thoracic surgery by the diagnosis of traumatic hemopneumothorax and the foreign bodies. We could remove two glass pieces.DiscussionI found 15 cases of intrathoracic foreign body without the patient's awareness in a Japanese medical central magazine for the years 1993–2015. In some cases identifying a glass piece on perioperative X-rays may be difficult. Thus, all means for determining the accurate number of glass pieces and their approximate positions should be used, including multi-slice CT. I realize that a preoperative strategy is also important.ConclusionThe patients who injured the chest with the glass without awareness of the implant of the foreign body, we take an intrathoracic foreign body by the penetration of the glass piece into consideration, need the search by the imaging. The extraction of the glass foreign bodies by VATS is very useful.