Case presentation On call team : Dr M Ragel Dr Iftkar 16/Jun/2011 Dr Malik

A 28-year-old Egyptian male was brought to ER approximately 30 minutes after sustaining injury to chest wall by a stone cutting saw.

On examination He is conscious oriented GCS 15/15 , not on respiratory distress but complained of 6/10 pain on deep inspiration in the mid-sternal

His vital signs were normal with a blood pressure of 130/86 mmHg, a heart rate of 89 bpm and room air oxygen saturation of 98% with respiratory rate 18 min.

Examination of the thorax revealed a 2cm length , 0.5 com width and 1.5 cm in depth laceration over lower third of sternum with no active bleeding .Chest symmetrical on expansion with equal air entry bilateral,no signs for distant or muffled heart sounds or jugular vein distention .

WBC 19 Hb. 15.2 Hct 43% PLT 193

Troponin-1 1.36

CPK876

LDH193

ECG done and showed no change.

-fracture of the sternum with F.B. Inside.-air in the anterior junction suggestive of pneumothorax with minimal pneumomediastinum, associated with surgical emphysema .-There is lung contusion including the left inferior lingula and segment of the medial lobe extended to the Rt & Lt anterior segments of the lower lobe

.

After CT scan vital signs were unchanged.

The chest wall wound was débrided and closed at the bedside, . The patient was admitted to hospital .

Overnight, the patient remained hemodynamically stable and completely asymptomatic with good analgesia.