Abstract

Introduction: Penetrating thoracic injuries are frequently encountered in emergency departments, most commonly resulting from stab wounds or firearm-related trauma. The clinical severity depends on both the mechanism of injury and the intrathoracic structures involved. In contrast, retention of a foreign body following penetrating chest trauma is a rare event and may pose significant diagnostic and therapeutic challenges. Such objects may remain clinically silent within the thoracic cavity, delaying recognition and increasing the risk of complications. Early diagnosis and timely intervention are therefore crucial. We report a unique case of a retained glass fragment following self-inflicted thoracic trauma with a broken beer bottle, successfully managed using video-assisted thoracic surgery (VATS).

Case Presentation: A 19-year-old male presented with a self-inflicted stab wound to the right anterior chest wall. Initial management at a regional hospital revealed a right-sided pneumothorax, treated with chest tube insertion and wound closure. A subsequent chest radiograph demonstrated a suspicious opacity in the right costodiaphragmatic angle, prompting thoracic computed tomography. CT imaging identified a triangular foreign body lodged in the right pleural base. The patient was transferred to our center, where a right-sided VATS was performed. Intraoperatively, a shard of the beer bottle was identified and safely removed. The pleural cavity was irrigated, and prophylactic antibiotics were administered.

Results: The postoperative course was uneventful. The chest drain was removed on postoperative day three, and the patient was discharged in good condition. At two-week follow-up, both the wound and port sites were healed, and a normal chest radiograph was obtained.

Conclusion: This case highlights the importance of maintaining a high index of suspicion for retained foreign bodies after penetrating thoracic trauma. VATS represents a safe and effective minimally invasive approach for diagnosis and definitive management in such rare and challenging scenarios.

Keywords: Penetrating thoracic trauma; retained foreign body; glass shard; video-assisted thoracic surgery (VATS); pneumothorax; minimally invasive surgery; chest injury; diagnostic challenge.