A “paneful” perforation

Johnston, Sally A; Lisle, David A; Borrowdale, Roderick C.

doi:10.5694/j.1326-5377.2007.tb00791.x

Cited by 4 publications

(10 citation statements)

References 2 publications

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“…In the literature, we only found 4 other cases of long-term presence of a piece of glass in the peritoneal cavity with delayed presentation after an impalement injury [8][9][10][11] (Table 1). All described cases had a common mechanism of injury -impact on a stationary object (type I by clinical classification of impalement injury) [12].…”

Section: Discussionmentioning

confidence: 99%

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Discovery of a Glass Splinter in the Abdominal Cavity After an Old Impalement Injury: A Case Report and Literature Review

Luks

Dworzyńska

Dobrogowski³

et al. 2020

Am J Case Rep

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Unusual clinical course Background:Intra-abdominal impalement injuries caused by a penetrating foreign body are rare and often fatal. The mechanism of injury is usually associated with vascular and organ damage, and the course is dynamic, with high morbidity and mortality. Post-traumatic presence of glass pieces in the peritoneal cavity after an old impalement injury is rare. Case Report:A 52-year-old woman sustained a 4-cm laceration in her lumbar region after falling on a glass table that shattered. After a physical examination and wound exploration in the emergency room, no foreign body was found.The laceration was sutured without X-ray imaging. She was admitted to the Surgical Department 9 months later for diagnosis of lower abdominal pain. In a CT scan of the abdominal cavity, a 19-cm fragment of glass was found intraperitoneally, inter-looped in the pelvic cavity. A laparotomy was performed, during which the foreign body was found and removed. No abdominal organs were injured. Further outpatient treatment was normal. Conclusions:Potentially minor abdominal impalement injuries can cause serious organ damage. Every patient, even if asymptomatic, and even after trivial injury with a small skin wound, must be suspected of having a hidden foreign body. Accurate visual, manual, and instrumental wound exploration is always necessary. Imaging exams are an important diagnostic method when the presence of a post-traumatic foreign body is suspected.

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Section: Discussionmentioning

confidence: 99%

“…In 2 of the 3 patients, delayed presentation of bowel damage occurred and resection was necessary [9,11]. In 1 patient, delayed closure of a colonic perforation with a linear stapler without resection was performed [10] and the late results were good.…”

Section: Discussionmentioning

confidence: 99%

Discovery of a Glass Splinter in the Abdominal Cavity After an Old Impalement Injury: A Case Report and Literature Review

Luks

Dworzyńska

Dobrogowski³

et al. 2020

Am J Case Rep

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“…They all had occult glass shards removed that measured 19, 16 and 8.5 cm in length, respectively. [21][22][23] Thus, glass tabletops represent a rare but ongoing cause of death in domestic situations, and account for a much larger number of non-lethal injuries, particularly in children. These tables should not be used as a substitute for chairs, particularly in overweight individuals, as this provides yet another circumstance where obesity increases the risk of injury.…”

Section: Discussionmentioning

confidence: 99%

Glass table tops: An unusual source of lethal domestic injury

et al. 2021

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A 42-year-old woman who fell through a glass tabletop had her lower back pierced by a long shard of glass. She rapidly exsanguinated. At autopsy, a single penetrating wound was present in her left lower back, with complete transection of her left kidney and a 3.5 L haematoperitoneum. Death was due to exsanguination following accidental transection of the left kidney by a penetrating glass injury of the lower back. Glass-topped tables are a well-recognised source of injury in a domestic setting There are far more non-lethal than lethal injuries, many of which involve children. Quite long shards may remain undetected in wounds for considerable amounts of time. Non-tempered glass is a particular risk for breakage. Glass-topped tables should not be used as substitutes for chairs, particularly in overweight or obese individuals.

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“…The patient's inability to recall any earlier accident or injury lends some support to this theory. In principle, the mechanism of impalement by falling on a glass table or falling on glass was previously reported twice for intrathoracic 10,20 and 5 times for intra-abdominal 59,[61][62][63][64] shards. However, there are reasons to be cautious about this hypothesis.…”

Section: Hypothesis Of a Current Impalement Traumamentioning

confidence: 99%

“…In fact, there are at least 7 known cases where relatively large glass shards deep within the body were overlooked. 8,17,18,37,60,[62][63][64] In addition, it is possible that the foreign bodies have undergone significant migration from their original location. The initial entry point and any overlooked scars may have been in a less expected and more peripheral location.…”

Section: Hypothesis Of a Previous Penetrating Traumamentioning

confidence: 99%

Foreign Glass Bodies in Pleura and Pancreas: Systematic Review for Entry Hypotheses and Treatment Options in an Unresolved Case

Ehrsam,

Meier Adamenko,

Schlumpf

et al. 2024

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: Foreign bodies within the pleura and pancreas are infrequent, and the approaches to their treatment still a subject of debate. There is limited knowledge particularly regarding glass foreign bodies. Methods: We present a case involving large glass splinters in the pleura and pancreas, with an unknown entry point. In addition, a systematic review was conducted to explore entry hypotheses and management options. Results: In addition to our case, our review uncovered eight incidents of intrapleural glass, and another eight cases of glass in other intrathoracic areas. The fragments entered the body through impalement (81%), migrated through the diaphragm after impalement (6%), or caused transesophageal perforation (19%) following ingestion. Eight instances of glass inside the abdominal cavity were documented, with seven resulting from impalement injuries and one from transintestinal migration. There were no recorded instances of glass being discovered within the pancreas. Among the 41 nonglass intrapancreatic foreign bodies found, sewing needles (34%) and fish bones (46%) were the most common; following ingestion, they had migrated through either a transgastric or transduodenal perforation. In all these cases, how the foreign bodies were introduced was often poorly recalled by the patient. Many nonglass foreign bodies tend to become encapsulated by fibrous tissue, rendering them inert, though this is less common with glass. Glass has been reported to migrate through various tissues and cavities, sometimes with a significant delay spanning even decades. There are cases of intrapleural migration of glass causing hemothorax, pneumothorax, and heart and major blood vessels injury. For intrapleural glass fragment management, thoracoscopy proved to be effective in 5 reported cases, in addition to our patient. Most intrapancreatic nonglass foreign bodies tend to trigger pancreatitis and abscess formation, necessitating management ranging from laparoscopic procedures to subtotal pancreatectomy. There have been only four documented cases of intrapancreatic needles that remained asymptomatic with conservative management. There is no direct guidance from the existing literature regarding management of intrapancreatic glass foreign bodies. Consequently, our patient is under observation with regular follow-ups and has remained asymptomatic for the past 2 years. Conclusions: Glass foreign bodies in the pleura are rare, and our report of an intrapancreatic glass fragment is the first of its kind. Impalement is the most likely method of introduction. As glass has significant migration and an ensuing complication potential, preventive removal of intrapleural loose glass should be considered. However, intrapancreatic glass fragment management remains uncertain.

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A “paneful” perforation

Cited by 4 publications

References 2 publications

Discovery of a Glass Splinter in the Abdominal Cavity After an Old Impalement Injury: A Case Report and Literature Review

Discovery of a Glass Splinter in the Abdominal Cavity After an Old Impalement Injury: A Case Report and Literature Review

Glass table tops: An unusual source of lethal domestic injury

Foreign Glass Bodies in Pleura and Pancreas: Systematic Review for Entry Hypotheses and Treatment Options in an Unresolved Case

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