Penetrating wood injury to axilla

Case contributed by Dr Andrew Dixon

Presentation

Motorbike accident into tree

Patient Data

Age: 25
Gender: Male

This case featured in our 2016 Trauma Radiology Course which is now available to view online.

A 4cm diameter tree branch penetrates through the left upper arm / pectoral region and passes through the left axilla where it has split at its mid section around the axillary neurovascular bundle before continuing through the sub scapular region before almost exiting the back of the body. The axillary artery is kinked by the wood but remains patent without obvious injury. The left axillary vein is focally compressed by the wood and probably completely obstructed. Near complete left lower lobe collapse is evident. No bony injury. 

Case Discussion

The low density of wood on CT (in this case somewhere between that of fat and air) 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. 

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