Surgical removal of a foreign body in the pulmonary artery

Foreign bodies, such as a fragmented catheter or metallic objects from industrial accidents, that have accidentally entered a major cardiac vessel or pulmonary artery have been successfully removed non-surgically via intravenous catheterization. We report the rare case of a cracked iron hammer fragment that had entered the femoral vein and migrated to the pulmonary artery through major blood vessels without causing hemorrhage, which eventually required surgical removal. A 19-year-old man accidentally smashed an iron hammer that broke into small pieces, one of which entered his femoral vein and eventually lodged in the pulmonary artery. After non-surgical intravenous catheterization to remove this foreign body was unsuccessful, it was removed surgically under video-assisted thoracoscopy. Foreign body residue over the long term can cause hemorrhage, pulmonary infarction, infection, and/or abscess. Transvenous recovery is the primary non-surgical means of removing a foreign body from the pulmonary artery. It is less harmful than surgical removal and causes fewer complications. Nevertheless, it is essential to be ready to execute a surgical approach for foreign body removal when other interventions have failed.