Successful surgery of massive thoracic injury in a girl following Chest trauma

Patients with penetrating thoracic injuries should be managed appropriately and rapidly under the supervision of multi-disciplinary team. We present a case of a 9-year-old female student who survived a major road traffic accident (RTA), a leading contributor to accidental deaths in Pakistan. The girl was hit by a public transport bus impaled by a metallic rod through the right axilla, and subsequently dragged for a distance, resulting in avulsion of a broad front of the mid-anterior and left precordial part of the chest wall. Although both the lungs and heart were exposed, she did not suffer any myocardial injury. Despite massive hypovolaemic shock with bilateral open pneumothoraces, the girl made an uneventful recovery. She was discharged on the 7thpost-operative day. The report highlights the value of proper management of hypovolaemic shock and optimally timed and executed surgical intervention.