First Case of an Accidental Penetrating Chest Wall Vascular Trauma by a Sikh Ceremonial Dagger

A 21-year-old male Sikh presented with accidental penetrating injury to left side of chest by his dagger (Kirpan). He sustained a large hematoma along the left lateral chest wall. On post contrast arterial phase, a focal contrast blush was seen within the large hematoma suggestive of active bleeding into the hematoma from a branch of axillary artery. We performed CT-guided surface marking of the site of bleeding vessel on the chest wall and centered our incision on the mark. Emergency surgery to remove the large clots and repair the bleeding artery was performed. This case can raise awareness about the possible cause of thoracic injury in Sikh patients carrying the dagger and the utility of CT-guided surface marking to localize the bleeding point in a huge hematoma.