A Very Unusual Case of Mediastinal Impalement Injury

Mediastinal impalement is a very uncommon and often fatal injury and one of the most severe types of penetrating chest injuries. Patients with this type of injury always undergo operative intervention regardless of the hemodynamic state or associated injury and only a few cases have been reported in which the patient recovered without any sequel. We present a previously unreported case of mediastinal impalement injury in which a 20-cm long stab was entered through the manubrium and remained within the anterior mediastinum with no cardiac, great vessel or hilar injury. The patient remained hemodynamically stable and the foreign body which had penetrated the pericardium and been stopped near the pulmonary artery was extracted via sternotomy incision. Follow-up of the patient for about 9 months revealed no complication or reidual effect of his accident.