Minimally invasive surgical management of penetrating chest injury from kinetic impact bean bag projectile

Bean bag guns are considered “non-lethal” weapons used by law enforcement. There are emerging reports in the medical literature on management of penetrating, intrathoracic injuries and none were found that involve potential cardiac complications. We present a case of a penetrating bean bag involving the pericardium. A young, adult man was shot in the left axillary region by law enforcement and presented hemodynamically stable. Computed Tomography (CT) demonstrated a bean bag anterolateral to the pericardium, associated with a small pulmonary contusion and hemopneumothorax. He underwent a left tube thoracostomy and sub-xiphoid pericardial window with cardiopulmonary bypass on standby. The diagnostic pericardial window showed no pericardial effusion and the foreign body extraction was successfully performed through the subxiphoid incision via Video Assisted Thoracoscopic Surgery. There were no intra-operative or post-operative complications.