A 47 year-old man was admitted to our hospital with a penetrating sternal wound from a sickle, after an attempted suicide, without dyspnoea, haemodynamically stable and a 20 cm blade penetrating into the superior mediastinum (Fig. 1). The chest radiograph demonstrates the blade abutting the spine (Fig. 2). The extraction of the blade was simply achieved by extending the wound anterior to the sternocleidomastoid muscle