Clinical Image
Thoracoabdominal Impalement by a Tree Branch
Empalamiento tóraco-abdominal por rama de árbol
María Teresa Gómez Hernández
, María Rodríguez Pérez, Marcelo Fernando Jiménez
Corresponding author
Departamento de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, Spain
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] 2 => array:2 [ "nombre" => "Marcelo Fernando" "apellidos" => "Jiménez" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Departamento de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Empalamiento tóraco-abdominal por rama de árbol" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1867 "Ancho" => 1867 "Tamanyo" => 382875 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest-abdominal computed tomography (A–B) showing a piece of wood, 20<span class="elsevierStyleHsp" style=""></span>cm long and 2<span class="elsevierStyleHsp" style=""></span>cm thick, with two distal ends (inverted Y-shape), extending in a craniocaudal direction from the left crus of the diaphragm to the psoas and left posterior paravertebral muscle. Surgical field images, showing the tree branch in the thoracic cavity (C) and the foreign body (D) after extraction under direct visual control.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 27-year-old male suffered an accidental fall onto the branch of a tree, resulting in thoracoabdominal impalement with entry site below the left clavicle. A chest-abdominal computed tomography (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A and B) revealed subcutaneous emphysema in the chest wall, large left pneumothorax with collapsed lung, parenchymal lesions in both lung lobes and the presence of a foreign body with air density, 2<span class="elsevierStyleHsp" style=""></span>cm thick, extending in a craniocaudal direction from the left crus of the diaphragm to the psoas and left posterior paravertebral muscle. It had two distal ends that terminated at the level of the left iliac crest.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Emergency surgery was performed, with left thoracotomy and lumbotomy. Surgical findings (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C and D) included hemothorax, lacerations in both lung lobes, with no vascular or bronchial involvement, and an inverted Y-shaped tree branch, 20<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>cm, incrusted in the diaphragm and psoas, in a retroperitoneal location. Plant remains were found in the pleural cavity.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The foreign body was removed under direct visual control, with lavage and suturing of the lung lacerations. The post-operative period was incident-free.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Gómez Hernández MT, Rodríguez Pérez M, Jiménez MF. Empalamiento tóraco-abdominal por rama de árbol. Arch Bronconeumol. 2015;51:468–469.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1867 "Ancho" => 1867 "Tamanyo" => 382875 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest-abdominal computed tomography (A–B) showing a piece of wood, 20<span class="elsevierStyleHsp" style=""></span>cm long and 2<span class="elsevierStyleHsp" style=""></span>cm thick, with two distal ends (inverted Y-shape), extending in a craniocaudal direction from the left crus of the diaphragm to the psoas and left posterior paravertebral muscle. Surgical field images, showing the tree branch in the thoracic cavity (C) and the foreign body (D) after extraction under direct visual control.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005100000009/v2_201509070947/S1579212915002189/v2_201509070947/en/main.assets" "Apartado" => array:4 [ "identificador" => "21342" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Clinical Image" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005100000009/v2_201509070947/S1579212915002189/v2_201509070947/en/main.pdf?idApp=UINPBA00003Z&text.app=https://www.archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212915002189?idApp=UINPBA00003Z" ]
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