CTICasesSelf-Inflicted Penetrating Mediastinal Foreign Body (Knife)
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Imaging findings
A portable chest radiograph displays a dense metallic artifact resembling a knife blade projecting over the superior mediastinum. The CT scout and axial images demonstrate a large knife blade traversing the neck and superior mediastinum, passing immediately to the left of the esophagus and splitting the space between the innominate artery and the left carotid artery. The tip of the blade extends into the spinal canal. Despite the trajectory, there is no evidence of major vascular injury, airway transection, or esophageal perforation.
Key takeaways
Penetrating mediastinal trauma from foreign bodies can occasionally follow a miraculous trajectory that bypasses major cardiovascular, airway, and esophageal structures. In cases of stable penetrating injuries, the foreign body should remain in place until controlled surgical or angiographic extraction is prepared. CT is invaluable for mapping the precise relationship of the object to vital mediastinal organs.
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See all cases from March 24, 2014 →