A RARE FOREIGN BODY IN THE CHEST UNDER COVID-19 EPIDEMIC CONDITIONS

Abstract

One of the negative factors of civilization around the world is the significant growth of injury rate. The manifestations of the latter include suicidal acts that occur in the process of social and individual life. Sometimes people commit suicide because of having incurable diseases. Alcohol addiction contributes to suicide risk. To share with the general medical community the rare case of suicidal trauma which seemed fatal but resolved favorably, though it was not immediately verified. Only after performing a radiological examination in two projections, the subject of suicidal action was detected. We observed a case of a suicide victim: a 55-year-old patient who, being impaired by alcohol, decided to commit suicide after learning about COVID-19 mortality. One hour later he was admitted to the emergency department. After stabbing himself with a kitchen knife, a 55-year-old patient called an ambulance and was delivered in satisfactory condition to the emergency surgical department 1 hour after the injury. There were no signs of bleeding or its consequences or manifestations of vena cava compression. Hemodynamics was stable; there were no external respiration disorders. Clinical blood test was within normal range. Revision of the wound in the lower neck was performed. At a depth of 2.5 cm, something perceived as a sternal notch was located manually, which later turned out to be a foreign body. Due to the location of the injury, it was decided to hospitalize the injured patient for observation. Plain and lateral radiography was performed. Longitudinal sternotomy was chosen for access. Under the entrance wound in the neck, in the lateral mediastinum above the root of the lung, a knife was found above the diaphragm penetrating the parenchyma of the lower lobe. After removing the knife, the lung wound was sutured. The postoperative period ended successfully. Before surgery, an imaging study with at least two different views is mandatory for all chest wounds. If possible, thoracotomy should be scheduled for the daytime.