Bulletin of Emergency And Trauma

An Unusual Case of Transorificial Abdomino-Thoracic Impalement Injury in a Child

Document Type : Case Report

Authors

Hemanshi Shah 1
Charu Tiwari 2
Shalika Jayaswal 2
Keshav Murthy 2

1 Professor and Head, Department of Paediatric Surgery, TNMC & BYL Nair Hospital, Mumbai Central, Mumbai. Maharashtra. India. Pin: 400008.

2 Department of Paediatric Surgery, TNMC & BYL Nair Hospital, Mumbai Central, Mumbai. Maharashtra. India. Pin: 400008.

Abstract
 Impalement injuries are rare in the paediatric age group. Still rarer are injuries which traverse multiple body cavities. Such injuries require multispecialty management at a tertiary care centre. We describe a case of an accidental impalement injury in a 12-year-old boy after a fall from height. The rod was seen passing through the right lung in the paracardiac region, piercing the diaphragm and segment IV of the liver and then coursing anterior to the inferior vena cava in the midline. It was seen passing through the small bowel at multiple places and then coursing behind the bladder, entering the rectum and anal canal. Intra-operatively, right intercostal chest drain was inserted. At laparotomy, the liver was mobilized and a diaphragmatic tear of 2×1cm was visualized. The rod traversed through the right lobe of liver with no active bleeding. Both the entry and exit sites through the liver were visualized. The rod was also seen passing through the small bowel and its mesentery. The rod entered the pelvis posterior to the bladder below the peritoneal reflection. Moderate hemoperitoneum and fecal contamination was present. The rod was successfully removed and the patient was discharged with good condition and was well on follow up.

Keywords

Impalement injury
Metal rod
Child
Bulletin of Emergency And Trauma
Volume 4, Issue 4 - Serial Number 4
25
Autumn 2016
Pages 236-239

  • Receive Date 06 May 2016
  • Accept Date 09 March 2019

Home

Guide for Authors

Publication Fee

Submit Manuscript

Forms

Guide for Reviewers

Contact Us