Abstract
Foreign body injury to mediastinal vascular structures may be present in clinically stable patients who have sustained thoracic trauma. Angiography may occasionally fail to demonstrate such an injury which may lead to delay in surgical management. A subtle roentgenographic finding consisting of a fuzzy metallic fragment contiguous with the mediastinum on admission chest films suggested vascular injury in two patients and prompted surgical exploration. Despite preoperative hemodynamic stability and normal angiograms, major transmural injuries to the pulmonary artery and aorta were encountered in these two patients and were managed successfully.
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