Unusual cause of domestic blast injury to the chest: Case report

Introduction and importance: Domestic blast chest injuries are because of suicide and accidents. Explosion injuries (trauma) are common in conflicts or military settings. Terrorists attacks result in injuries among the civilian population. A case of a 52-year-old African man who had an oxygen canister/grinder explode on him whilst working with it is reported. This case confirms that the mortality rate of patients with chest blast injuries who reach the hospital is low at less than 5 %. Case presentation: A 52-year-old man suffered a blast injury from an exploded oxygen canister in July 2018. The shrapnel entered his chest, shattering his ribs and causing lung lacerations. He underwent urgent thoracotomy to remove the foreign body and chest wall reconstruction. Complications included clotted haemothorax and rhabdomyolysis, leading to acute kidney injury, and requiring dialysis. He was discharged after seven weeks. Clinical discussion: Thoracic blast injuries can occur at various subcellular levels. Management involves primary and secondary surveys, followed by patient disposition. Unstable patients require immediate definitive and/or damage control treatment, while stable patients benefit from radiological investigations (chest X-ray, E-FAST, CT-scan) and physiological studies (blood gas analysis, full blood count (FBC), urea, electrolytes and creatinine (UEC) analysis, cardiac markers, and clotting profile evaluation. Definitive management is tailored to the injury's severity and location. Blast injuries are classified into four categories: primary, secondary, tertiary, and quaternary. Our patient had secondary and quaternary injuries. The management depends on patient stability. Conclusion: Effective management protocols are essential to improve survival rates in blast-related chest trauma.