Cut the grass in the fence, build barbed wire straight through the belly wall

Male patient HVB, 35 years old, address in Can Tho, working in Phu Quoc – Kien Giang, entered the Emergency Department of Can Tho Central General Hospital at 3:40 pm on May 2, 2022 with an injury. ¼ on the right abdomen should be about 2x5mm in size.

One day before, the patient used a lawn mower at the fence, cut a broken barbed wire through the abdomen, then saw a light wound and pain, not serious, little bleeding, so he did not go to the doctor.

About 12 hours later, the patient was tired, short of breath, and had more and more chest pain, so he went to a local hospital for examination and was quickly transferred to Can Tho Central General Hospital.

The results of straight chest X-ray, echocardiography, and contrast-enhanced computed tomography showed 01 contrast medium 4×0.4cm long, located along the posterior wall of the left ventricle and had a shunt into the heart chamber. The patient is indicated for emergency surgery.

Foreign body on film.

Surgery team led by Dr. CK2 Tram Cong Chat – Head of Department, MSc. Lieu Vinh Dat – Deputy Head of Department (thoracic surgery – Vascular), BSCKII. Nguyen Thanh Liem (Department of Anesthesiology and Resuscitation) opened the pericardium and found that there was little blood thinning and clots, many pseudomembranous areas along the right side of the heart and the back of the heart.

Investigation revealed that the diaphragm has a small wound that has been closed, the posterior wall of the left ventricle is bruised about 3x3cm with a pseudomembranous membrane, there is a small wound on the heart muscle wall, on the surface of the left ventricular posterior wall, a foreign body can be seen, proceed to pick it up. The foreign body is a metal piece 4×0.4cm long, blood spurts out in a jet.

The doctors sutured the left ventricular posterior wall, checked hemostasis carefully, pumped the pericardial cavity, and closed the pericardium. The surgery took place successfully after 120 minutes.

On the afternoon of May 4, 2022, the patient was awake, breathing on his own, his vital signs were stable, the incision was dry, he continued to be monitored and treated at the Department of Thoracic – Vascular Surgery.

The doctor examines the patient.

The hospital has received cases of patients with lawn mower blades causing injuries such as broken legs, hand, chest, and abdomen injuries. The cause of accidents caused by lawn mowers is largely due to the subjectivity of the user.

During operation, just losing concentration can cause the blade of the lawn mower to splash on the foot or the blade to touch the stone…

When using the lawn mower, always wear closed-toe shoes, work clothes, gloves and safety glasses. Besides, users also need to pay attention to the terrain, avoid places with rocks, metal and other sharp objects…

In particular, when there is an injury in the process of living and working, people need to go to a medical facility to be carefully examined, early detection of injuries and timely treatment.

According to BSCKII. Tram Cong Chat: This patient’s case is quite rare because with the above injury location, the most common direct damage is the liver and intestines, but the patient only has a heart wound in a complicated location.

Heart injury is a very serious injury, which is considered an emergency in the surgery of cardiovascular thoracic surgery. These are lesions with a high mortality rate if not diagnosed and treated promptly.

Heart wound surgery is very complicated, high difficulty, requires experienced specialist surgeons, capable of suturing the wound quickly and with correct technique on a beating heart.

Large centers have enough modern medical equipment and experienced emergency staff, surgeons, anesthesiologists and resuscitators are important factors contributing to high success in treatment.

K.Chi