Penetrating wood foreign body injury to axilla

Case contributed by Dr Andrew Dixon

Presentation

Car accident into a tree.

Patient Data

Age: 25
Gender: Male

A 10 x 5 x 4 cm wood foreign body has penetrated through the right supraclavicular region into the right axilla. There has been traumatic injury to the axillary vein while the artery remains patent. The brachial plexus is intimately related to the axillary vessels and injury would be likely. 

Bone windows nicely demonstrate the wood as being similar to fat density. 

Case Discussion

Penetrating wood injury to axilla with large chunk of wood remaining within the body. The low density of wood on CT (similar to fat density) can mean that it is not infrequently mistaken for air on standard soft-tissue windows by the inexperienced reader. It is important to use lung or bone windows to help differentiate between air and wood. This patient sustained a persistent lateral cord injury to the brachial plexus as a result of this trauma. 

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