Surgical management of a thoracic trauma caused by the penetration and retention of a knife: a case report from a resource-limited setting

Introduction: Retained intrathoracic foreign bodies following penetrating chest trauma are uncommon and are associated with a high risk of major vascular or pulmonary injuries. Their management may be particularly challenging in resource-limited settings where advanced imaging and minimally invasive surgical techniques are unavailable. Presentation of case: An 18-year-old man presented to the emergency department with a knife retained in the right posterior thorax for approximately 17 hours following a stab injury. The patient was hemodynamically stable on admission. Chest radiography and ultrasonography revealed a right hemopneumothorax. Due to the prolonged retention of the foreign body, concerns about associated thoracic injuries, and limited technical resources, the patient underwent an open thoracotomy with successful removal of the knife and repair of pulmonary injuries. The postoperative course was uneventful. Discussion: Management of retained thoracic foreign bodies requires careful perioperative planning to avoid catastrophic complications during removal. In low-resource settings, surgical decision-making may rely mainly on clinical assessment, basic imaging modalities, and intraoperative exploration when advanced imaging is unavailable. Conclusion: This case highlights that open thoracotomy remains a safe and effective option for managing penetrating thoracic trauma with retained foreign bodies in resource-limited environments.