Case of a penetrating injury caused by a Japanese sword (katana)
CASE REPORT:A 91-year-old male stabbed his chest and abdomen and cut his head with a katana and was found in a coma by his family. His history included dementia, schizophrenia, hypertension, and diabetes mellitus. The patient was in a deep coma and also a state of severe hemorrhagic shock. Emergency thoracotomy was performed in the operating room. The patient temporally exhibited pulseless electrical activity due to massive hemorrhage, and fluid resuscitation resulted in spontaneous circulation. Injuries of the lingual, left pulmonary artery, and diaphragm were found, and primary closure of the pulmonary artery with clamping of the pulmonary hilum, primary closure of the diaphragm, and lobectomy of the lingual region were performed. The abdominal stab wound did not reach the intra-abdominal cavity and was also closed. After the operation, the patient developed pyothorax and was treated with antibiotics. He achieved a full somatic recovery and was transferred to a psychiatric hospital. The patient was successfully treated, despite his advanced age and severe shock state.
