An Unusual Occurrence of Penetrating Aortic Arch Injury by a Ball‑point Pen: a case report and review of the literature

dc.contributor.authorAriaka, Herbert
dc.contributor.authorMagala, John Paul
dc.contributor.authorKebba, Naomi
dc.contributor.authorKabuye, Ronald
dc.contributor.authorNamirembe, Stella Magara
dc.contributor.authorNalule, Miriam
dc.date.accessioned2025-09-22T13:34:49Z
dc.date.available2025-09-22T13:34:49Z
dc.date.issued2022-12-12
dc.description.abstractAortic arch injuries account for about 8% of thoracic aortic injuries. Penetrating zone I neck injuries account for 18% of vascular injuries in the neck and have great potential to traverse to involve thoracic vascular structures as well. The hard and soft signs of vascular injury facilitate triage of patients on an individual basis. We present a case of a ball-point pen traversing through zone I of the neck and causing penetrating aortic arch injury with minimal mediastinal haemorrhage. We present a polytrauma patient who was admitted with traumatic brain injury and a ball-point pen lodged above the sternal notch in zone I of the neck following a road traffic accident. He underwent mediastinal exploration via a median sternotomy. The ball-point pen was found penetrating the anterior wall of the aortic arch and resting in its lumen. The ball-point pen was successfully explanted and primary repair of the penetrating aortic arch injury was done. He had an uneventful recovery without any added secondary neurological complications. Penetrating aortic arch injuries are rare compared to injuries of the ascending aorta and descending aorta. They require a high index of suspicion, rapid investigation and urgent intervention in view of their high associated fatality. The ball-point pen in this case assumed the shape of a plug which acted as a seal at the site of injury preventing catastrophic exsanguination.
dc.identifier.citationAriaka, H., Magala, J. P., Kebba, N., Kabuye, R., Namirembe, S. M., Mwambu, T. P., ... & Nalule, M. (2022). An unusual occurrence of penetrating aortic arch injury by a ball-point pen: a case report and review of the literature. Journal of Cardiothoracic Surgery, 17(1), 312.
dc.identifier.otherhttps://doi.org/10.1186/s13019-022-02057-5
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/12086
dc.language.isoen
dc.publisherJournal of Cardiothoracic Surgery
dc.titleAn Unusual Occurrence of Penetrating Aortic Arch Injury by a Ball‑point Pen: a case report and review of the literature
dc.typeArticle
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