Management of Penetrating Thoracoabdominal Trauma in a Resource-Limited Setting: A Case Report

Trauma remains a major global health challenge, particularly in low- and middle-income countries where access to advanced surgical resources is limited. This case report describes the management of penetrating thoracoabdominal impalement in a resource-constrained hospital in Honduras during a Medical Readiness Training Exercise (MEDRTE). An adult male presented after being impaled by a metal spike through the left thoracoabdominal region. With limited imaging and no access to blood products, the patient underwent emergent exploratory laparotomy and thoracotomy. Injuries included gastric perforation, splenic laceration, diaphragmatic injury, pulmonary laceration, and a pericardial tear. The patient recovered without complications and was discharged on postoperative day 5. This case highlights the challenges of trauma care in austere settings and underscores the importance of surgical adaptability and real-world training experiences such as MEDRTE deployments.