Analytical review of 664 cases of penetrating buttock trauma

Abstract

A comprehensive review of data has not yet been provided as penetrating injury to the buttock is not a common condition accounting for 2-3% of all penetrating injuries. The aim of the study is to provide the as yet lacking analytical review of the literature on penetrating trauma to the buttock, with appraisal of characteristics, features, outcomes, and patterns of major injuries. Based on these results we will provide an algorithm. Using a set of terms we searched the databases Pub Med, EMBASE, Cochran, and CINAHL for articles published in English between 1970 and 2010. We analysed cumulative data from prospective and retrospective studies, and case reports. The literature search revealed 36 relevant articles containing data on 664 patients. There was no grade A evidence found. The injury population mostly consists of young males (95.4%) with a high proportion missile injury (75.9%). Bleeding was found to be the key problem which mostly occurs from internal injury and results in shock in 10%. Overall mortality is 2.9% with significant adverse impact of visceral or vascular injury and shock (P < 0.001). The major injury pattern significantly varies between shot and stab injury with small bowel, colon, or rectum injuries leading in shot wounds, whilst vascular injury leads in stab wounds (P < 0.01). Laparotomy was required in 26.9% of patients. Wound infection, sepsis or multiorgan failure, small bowel fistula, ileus, rebleeding, focal neurologic deficit, and urinary tract infection were the most common complications. Sharp differences in injury pattern endorse an algorithm for differential therapy of penetrating buttock trauma. In conclusion, penetrating buttock trauma should be regarded as a life-threatening injury with impact beyond the pelvis until proven otherwise.

Foreign Body in Sacral Region: Remaining Part of Knife After Stabbing

“…It has been reported that total mortality rate of penetrating injuries of buttock 2.9%, stabbing injury mortality rate 3.8% and gunshot injury mortality rate 2.6% in literature. 1,2 In our case, there is no neurologic, vascular or visceral injuries but only stuck in S2 vertebral spinous. Remaining foreign bodies after penetrating injuries occur by firearm, blastic and stab injuries or accidents.…”

Penetrating Sharp Object Injury in the Gluteal Region and Small Bowel Perforation Due to Pelvic Penetration: A Case Report

“…Surgery, angioembolization or observation could be preferred according to the observed bleeding and abdominal injuries. 2 In 2014, Lunevicius et al, 8 updated the algorithm and recommended evaluation in the following order: general inspection of the patient, controlling the femoral pulse, neurological examination of the lower extremities, examination of urethra and rectum, and then rectoscopy was suggested after the patient became stable. 9 Radiologists recommend contrast-enhanced rectal CT if there is still clinical suspicion of rectal injury despite rectoscopy.…”

An unusual stab wound to the buttock

“…Actually, there is a higher mortality from gluteal stab wounds compared with gluteal gunshot wounds. [ 4 ] This may be related to the delayed diagnosis of serious injuries caused by the false sense of security of what appears to be a simple wound. [ 2 ] Penetrating wounds to the buttock can cause serious vascular injuries (gluteal vessels, iliac vessels), nerve damage (the sciatic nerve, gluteal nerve) or pelvic and abdominal visceral injuries, depending on the direction and depth of the wound.…”