An unusual case of transpelvic impalement injury: A case-report
| Autor: | Mushrek Alani, Saeed Mahmood, Sajid Atique, Ruben Peralta, Hassan Al-Thani, Ayman El-Menyar |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Exploratory laparotomy Impalement injuries medicine.medical_treatment Transpelvic Trauma Article law.invention Intramedullary rod 03 medical and health sciences 0302 clinical medicine law medicine Pelvis Femur fracture Unusual case business.industry Sigmoid colon Surgery medicine.anatomical_structure 030220 oncology & carcinogenesis Orthopedic surgery 030211 gastroenterology & hepatology Presentation (obstetrics) business |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| DOI: | 10.1016/j.ijscr.2017.08.068 |
| Popis: | Highlights • Transpelvic impalement injury is a rare serious mechanical injury. • The impaling object should be left in situ until the initiation of management at tertiary trauma center. • Careful planning for removal of impaling object is crucial to minimize blood loss and preserve the involved organ function. • Time is important when evaluating and resuscitating such patients. • Treatment needs a multidisciplinary team with coordinated approach and early imaging studies. Introduction Impalement injury is a rare type of mechanical injury following forceful insertion of projecting object into the body. Careful planning for removal of the impaling object is essential to decrease the blood loss and preserve the function of the injured organ. Presentation of case A 27 year-old male fell from 4 m height over a U shaped projecting up metallic bar. The bar penetrated the left side of the pelvis and traversed through the left iliac bone causing a comminuted fracture in the supra-acetabular region extending to the left psoas muscle, injuring the viscera and causing fracture of the right femur. Exploratory laparotomy was performed and the metallic bar was pulled out from the sigmoid colon through the inlet of the injury. Intramedullary nailing was performed for femur fracture. The patient developed infection (Methicillin-sensitive Staphylococcus aureus and Escherichia coli) during the post-operative course that was successfully managed with antibiotic therapy. Finally the patient was sent home after a week in a good health condition. Discussion Two surgical teams worked in sequence to fix the injuries starting with the trauma team followed by the orthopedic surgeons. Conclusion Impalement injury is a serious injury that needs a multidisciplinary team with a coordinated approach to achieve a favorable outcome. |
| Databáze: | OpenAIRE |
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