Migración de un clavo de Kirschner a mediastino

introduction: metallic implants, as the kirschner wire are commonly used in orthopedics. they can migrate and produce various and potentially severe complications. clinical case: an 86 year old woman had a chronic luxation of the right shoulder treated by internal fixation with a 17.3 cm kirschner wire. she was asymptomatic when seen six months later at the outpatient clinic; the chest x ray and ct scans showed the kirschner wire crossing through the mediastinum, from right to left, perforating both lungs and the left pulmonary artery, in close vicinity to the aorta, the esophagus and a vertebral body. the wire was removed through a left posterolateral thoracotomy producing a laceration of the left pulmonary artery that was repaired with 5-0 vascular sutures. she is doing well. the pertinent literature is reviewed.