Perineal impalement injury by steel bar — A near miss

Abstract

Adult perianal impalement injuries are uncommon but can carry high morbidity and mortality. We report a case of a penetrating perineal trauma in a construction worker highlighting an innovative use of a Sengstaken tube to control his pelvic bleeding, as well as the operative management of his sphincteric injury. This article illustrates principles of effective acute care and discusses a diagnostic approach to evaluating a potentially complex injury, as well as the decision-making process with regard to fecal diversion and choice of sphincteric repair.

Perineal impalement extending through multiple cavities by iron rod following fall from elevated plane: Case report

“…These injuries often occur in situations of falls from heights, more commonly observed among construction workers [ 1 ]. However, they are also documented in contexts of sexual abuse and physical assaults [ 2 ]. As an aggravating factor in the prognostic perspective, the risk of pelvic bleeding [ 2 ] is highlighted, as the region houses important blood vessels, and their compromise can trigger hemorrhagic shock.…”

“…However, they are also documented in contexts of sexual abuse and physical assaults [ 2 ]. As an aggravating factor in the prognostic perspective, the risk of pelvic bleeding [ 2 ] is highlighted, as the region houses important blood vessels, and their compromise can trigger hemorrhagic shock. In the face of this scenario, the survival and recovery of patients subjected to this type of injury depend on factors such as pre-hospital care, involvement of vital organs, the amount of blood loss, and the effectiveness of blood component replacement during initial care, as well as late trauma complications [ 2 ].…”

“…As an aggravating factor in the prognostic perspective, the risk of pelvic bleeding [ 2 ] is highlighted, as the region houses important blood vessels, and their compromise can trigger hemorrhagic shock. In the face of this scenario, the survival and recovery of patients subjected to this type of injury depend on factors such as pre-hospital care, involvement of vital organs, the amount of blood loss, and the effectiveness of blood component replacement during initial care, as well as late trauma complications [ 2 ]. The scientific literature records scarce cases of impalements of extensive magnitude, partly attributed to the high mortality rate of these victims at the scene of the incident [ 3 ].…”

Impalement injury of the perineum with an iron rod with a minimal injury: A near miss: A case report

“…Impalement injury constitutes the penetration of the body by an object such as a rod, pole, etc, alongside the complete perforation of a central body mass. These types of injuries are often life-threatening with high morbidity and mortality owing to their complex injury patterns and risk of massive pelvic bleeding [ 3 ]. Herein, we report a case of a 13-year-old boy who sustained a minimum injury despite penetrating construction iron rod injury traversing from the perineum to the left loin.…”

Conservative management of abdominoperineal impalement trauma – A case report

“…In Central Europe abdominal penetrating trauma, such as stab injuries or gunshot wounds, is very uncommon with a low incidence (0.1%) [ 1 ]. Adult perineal impalement injuries are even more uncommon, there are several vital organs that could be damaged in pelvic cavity, thus they usually present with complex injury patterns and risk of massive pelvic bleeding [ 2 ]. In many cases, impaled patient dies at the scene [ 3 ], but the ones who manage to reach the hospital alive and are hemodynamically stable have a good chance of overcoming traumatic event.…”