Thoracoabdominal impalement by a tree branch.

A 27-year-old male suffered an accidental fall onto the branch of a tree, resulting in thoracoabdominal impalement with entry site below the left clavicle. A chest-abdominal computed tomography (Fig. 1A and B) revealed subcutaneous emphysema in the chest wall, large left pneumothorax with collapsed lung, parenchymal lesions in both lung lobes and the presence of a foreign body with air density, 2 cm thick, extending in a craniocaudal direction from the left crus of the diaphragm to the psoas and left posterior paravertebral muscle. It had two distal ends that terminated at the level of the left iliac crest.