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Aisyah Binti Razali Maizatul Aliaa AM Diong NC Normah I Mathew T

Abstract

INTRODUCTION


Foreign objects embedded in the body, especially in chest trauma are a common problem in emergency departments. While some retained foreign bodies are missed in initial presentation, these retained objects may result in various complications such as pain and infection at a later stage. We describe a case of foreign body retained in the right supraclavicular fossa, its challenges on identifying on diagnostic imaging and surgical retrieval of the item.


CASE DESCRIPTION


A 21 year-old gentleman presented to the emergency department following a fall in the toilet. He complained of persistent pain over the right shoulder and an initial chest radiograph shows subcutaneous emphysema with no hemopneumothorax. Computed tomography (CT) Thorax was done before he was subjected to wound exploration and foreign body removal surgery on post trauma day three due to diagnostic dilemma. A broom cap was retrieved from the right supraclavicular fossa with a notable track to the wound at his right axilla.


DISCUSSION


Organic foreign bodies are radiolucent because their density is similar to surrounding structures and may mimic air pockets or remain isodense to surrounding soft tissues depending on the imaging modality. Such cases may become a challenge to diagnose and this may result in delay in definitive treatment.


CONCLUSION


This case illustrates the importance of history and through advancement of imaging modalities, interpretation and diagnosis should be done promptly so as to correctly identify and retrieve these foreign bodies to prevent serious complications to patients.

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