Chest, pericardium, abdomen, and thigh penetrating injury by a steel rebar: A case report

BACKGROUND: Combined penetrating trauma involving the chest, pericardium, abdomen, and thigh is rare and lethal. It is difficult to quickly rescue patients with penetrating injuries from long steel bars. CASE SUMMARY: A previously healthy 56-year-old male worker presented with a length of rebar that penetrated the chest-abdomen-pelvic cavity and was palpable on the anterior side of the neck and thigh. On radiological imaging, the left chest wall-left chest cavity-mediastinum-abdominal cavity-right groin area-right thigh demonstrated a strip-like density shadow, about 1.5 cm thick, with the heart, stomach wall, and part of the intestine involved. There was a left-sided pleural effusion, left lung compression of about 50%-60%, and a small amount of left pleural effusion/blood accumulation; possible perforation of hollow organs; and double multiple ribs fractures on the side. An emergency green channel was opened to provide a rescue process for smooth and timely diagnostic and treatment to save the patient's life. The patient was followed at 4 mo after discharge and showed good recovery. CONCLUSION: For pre-hospital emergency treatment in locations that are not fully prepared for surgery, we do not recommend cutting the steel bars outside the body. We advocate pulling out foreign bodies intact to reduce secondary injuries.