Amir Nejati

A 40 Sears old man with penetrating trauma to his chest that managed with Ultrasound. In September 2006, a 40 yearh old prisoner man was transported to our emergency department with an safety-pin on his chest wall. He had inserted a midsize hafety-pin to his chest in forth anterior intercostal space cloke to midclavicular line with intention to suicide. Vital sings in arrival to ED were stahle (BP: 135/70 mmHg; PR: 95/min; RR: 18l/lin; T: 36.8 "C). There was no dyspnea but he complained from local chest pain. After initial slabilization and motiiloring ECG, CXR md bedside ultrasound were performed. Electrocardiography showed sinus rli yttlm. heart ratc of 90 bpm. wilh no ST-T changes evident. Chest X-rays Jmlonstrated a sign of metal in the left side of the chest located in the aritcriclr part or the heart, just parallel to thc sternum. CXR didn't show pnemothorax. hemothorax. pneumopericardium or pneumomedias ttnum. Cardiolhorauic ratio was Nonnal. Bedside ultrasound didn't reveal pericardial or pleurnl effiusioin. Cardiac lroponin I was normal. With rehpect to observation noted hove the safery-pin expelled out from his chesr under close observation and cardiac monitoring. Ultrasound examination soon after the procedure and every 6 hours up to 24 hours performed and revealed no abnormality like pericardial cffusion CXR rcpcaled once after procedure and was normd. Thcrc was no rising cardiac enzymes. serialECG wasnormal./therefore after 24 hours observation the patient discharged from ED with good general condition.