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July 1996

Radiological Case of the Month

Author Affiliations

From the Center for Injury Research and Control, University of Pittsburgh (Pa), and the Division of Emergency Medicine, Children's Hospital of Pittsburgh (Dr Kinnane); and the Division of Emergency Medicine, Children's Hospital, Boston, Mass (Dr Stack).

Arch Pediatr Adolesc Med. 1996;150(7):759-760. doi:10.1001/archpedi.1996.02170320105018

A 3-YEAR-OLD boy was brought by paramedics to the emergency department with a penetrating chest injury. He had been unintentionally stabbed with a barbecue skewer by his 11-year-old sister. On arrival, he was awake and alert with a blood pressure of 116/60 mm Hg, heart rate of 122/min, respiratory rate of 22/min, and a room air oxygen saturation of 100%. The trachea was midline, breath sounds were clear bilaterally, and heart sounds were normal. The skewer entered the skin below the left lateral clavicle and its tip was tenting the skin on the patient's left upper back. The neurovascular system of the upper extremities was intact and there was no visible bleeding. Results of the remainder of the physical examination were unremarkable.

Anteroposterior and lateral chest radiographs were obtained (Figure 1 and Figure 2). Arteriography was performed (Figure 3).

Denouement and Discussion 

Penetrating Chest Trauma in Children  Injuries are the