Asymptomatic retained knife blade following stab wound to the chest: A rare presentation

Abstract

Penetrating thoracic trauma from stabbing is a common emergency presentation. However, the retention of a knife blade within the thoracic cavity with delayed, asymptomatic presentation is exceedingly rare. We report the case of a 28-year-old male who remained asymptomatic for three days following a stab wound to the right hemithorax sustained during a physical altercation. The handle of the knife detached, leaving the blade completely embedded in the chest. Upon presentation, the patient was hemodynamically stable and reported no respiratory or cardiovascular symptoms. A chest radiograph revealed a retained metallic object consistent with a knife blade within the right hemithorax. The patient underwent right posterolateral thoracotomy, during which the blade was retrieved and a parenchymal laceration of the right lung was identified and repaired. The thoracic cavity was closed over a chest tube. The postoperative course was uneventful, and the patient was discharged in good condition. Retained knife blades following penetrating chest trauma are uncommon, and their asymptomatic presentation is exceptional. The absence of early complications can be attributed to a non-transfixing trajectory that spares major vascular and visceral structures. Prompt imaging remains essential for diagnosis and surgical planning. Even apparently benign stab wounds require systematic imaging evaluation. Retained foreign bodies may remain clinically silent but carry potential for delayed complications, emphasizing the importance of thorough radiological and surgical assessment in all penetrating thoracic injuries. • Retained knife blades in the thoracic cavity are rare but potentially life-threatening injuries. • Thorough radiographic and CT evaluation is essential to determine the position and depth of the foreign body. • A multidisciplinary approach involving trauma surgeons, thoracic surgeons, and radiologists ensures safe management. • Surgical extraction via thoracotomy allows direct visualization and control of possible vascular or bronchial injury.