The spectrum of injuries in buttock stab wounds

Campion, Tom; Cross, Susan

doi:10.1016/j.crad.2017.02.009

Cited by 6 publications

(17 citation statements)

References 12 publications

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“…One major trauma centre reports a fourfold increase in gluteal and perineal stab wounds in recent years 1. As in this case, most injuries occur in young men1 2; however, they only account for 2%–3% of all reported penetrating injuries 3 4.…”

Section: Discussionmentioning

confidence: 55%

Buttock wounds: beware what lies beneath

et al. 2017

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A 25-year-old man presented to a major trauma centre with multiple stab wounds, most significantly to the right buttock. Triple-phase CT revealed no acute bleeding and his wounds were closed. In the month following injury, he re-presented seven times to the emergency department (ED) complaining of bleeding and wound breakdown. After his seventh ED attendance, he was examined under general anaesthesia. Intraoperatively, profuse arterial bleeding was encountered and the local major haemorrhage protocol was activated. The on-call consultant vascular surgeon attended and definitive control was achieved. A large haematoma had acted to tamponade ongoing arterial bleeding and an underlying pseudoaneurysm: a finding not reported, but present, on the initial CT angiogram. Following 24 hours in the intensive care unit, he was transferred to the surgical ward and discharged 4 days later. Regular review in the outpatient department over the following 9 weeks monitored successful wound healing.

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Section: Discussionmentioning

confidence: 55%

Buttock wounds: beware what lies beneath

et al. 2017

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“…This reflects local data from another level 1 trauma center within the same city. 1 There may be some inaccuracy with the older data in this study due to slightly less mature data systems and processes of data capture; however, there is evidence that the regional increase in the presentation has been part of a nationwide increase in knife crime. 6 Due to the complex behavioral and socioeconomic factors associated with knife crime, it is difficult to propose the Open access reasons behind the increase in PGI; however, anecdotally there remains a stigma within this cohort around these injuries and the associated stoma, suggesting that there is a degree of purposeful anatomic targeting.…”

Section: Discussionmentioning

confidence: 76%

“…This was due to the recognized increase in this injury pattern locally. 1 Vascular injury was defined as either presence of active bleeding or injury to a vessel seen on CT imaging. Data was collected and analyzed using Microsoft Excel V.16.16 (Microsoft, Seattle, USA), and further statistical analysis was performed using R V.4.0.2 (R Core Team, Vienna, Austria).…”

Section: Methodsmentioning

confidence: 99%

Penetrating gluteal injuries in North West London: a retrospective cohort study and initial management guideline

McKnight

Yalamanchili

Sanchez-Thompson

et al. 2021

Trauma Surg Acute Care Open

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BackgroundPenetrating gluteal injuries (PGIs) are an increasingly common presentation to major trauma centers (MTCs) in the UK and especially in London. PGIs can be associated with mortality and significant morbidity. There is a paucity of consistent guidance on how best to investigate and manage these patients.MethodsA retrospective cohort study was performed by interrogating prospectively collected patient records for PGI presenting to a level 1 MTC in London between 2017 and 2019.ResultsThere were 125 presentations with PGI, accounting for 6.86% of all penetrating injuries. Of these, 95.2% (119) were male, with a median age of 21 (IQR 18–29), and 20.80% (26) were under 18. Compared with the 3 years prior to this study, the number of PGI increased by 87%. The absolute risk (AR) of injury to a significant structure was 27.20%; the most frequently injured structure was a blood vessel (17.60%), followed by the rectum (4.80%) and the urethra (1.60%). The AR by anatomic quadrant of injury was highest in the lower inner quadrant (56%) and lowest in the upper outer quadrant (14%). CT scanning had an overall sensitivity of 50% and specificity of 92.38% in identifying rectal injury.DiscussionThe anatomic quadrant of injury can be helpful in stratifying risk of rectal and urethral injuries when assessing a patient in the emergency department. Given the low sensitivity in identifying rectal injury on initial CT, this data supports assesing any patients considered at high risk of rectal injury with an examination under general anesthetic with or without rigid sigmoidoscopy . The pathway has created a clear tool that optimizes investigation and treatment, minimizing the likelihood of missed injury or unnecessary use of resources. It therefore represents a potential pathway other centers receiving a similar trauma burden could consider adopting.Level of evidence2b.

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“…However, there may be vascular, intestinal, genitourinary and sciatic nerve injuries depending on the depth and trajectory of penetration. 6 The upper zone and the lower zone are formed when the gluteal region is divided into two from the intertrochanteric line. Mortality and morbidity of the upper zone injuries are higher than the lower zone.…”

Section: Discussionmentioning

confidence: 99%

“…9 Radiologists recommend contrast-enhanced rectal CT if there is still clinical suspicion of rectal injury despite rectoscopy. 6 There is no standard treatment for pelvic wounds. 10 In our case, the examination of the rectum, genital organs, femoral and distal pulses were performed.…”

Section: Discussionmentioning

confidence: 99%

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

Yüksel¹,

Üstüner²,

Karayiğit³

et al. 2019

tjcd

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98 IntroductionThe gluteal region is anatomically located between iliac wings, inferior gluteal folds and bilateral greater trochanter. 1 Penetrating sharp object injuries (PSOIs) in the gluteal region are rare and constitute 2-3% of all injuries. 2 These injuries generally do not pose serious health problems. However, visceral and vascular injuries leading to life-threatening events can be observed in one-quarter of the cases. 3 To the best of our knowledge, little research has been conducted on visceral and vascular injuries in the gluteal region. In this study, we present a case of small bowel perforation arising from an injury in the gluteal region. We hope our study will bring more interest to the subject and contribute to the scarce literature. Case ReportA 24-year-old male patient was admitted to the Emergency Department of Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital with a PSOI in the gluteal region. Physical examination of the patient revealed 1 cm incision in the superior zone of the left gluteal region at 10 o'clock and eviscerated gangrenous ileum loop in the superior zone of the right gluteal region at 9 o'clock ( Figure 1). The vitals were stable. A urinary bladder catheter was inserted and ÖZ Gluteal bölgedeki kesici delici alet yaralanmaları sık görülmektedir. Ancak bu yaralanmaların pelvise penetrasyon göstererek ince barsak perforasyonuna sebep olması çok nadirdir. Penetrasyon derinliği arttıkça, yaralanma yerinin lokalizasyonuna bağlı olarak vasküler yaralanma, barsak yaralanması, genitoüriner yaralanma gibi hayatı tehdit eden yaralanmalar olabilir. Bu olgu sunumunda hastaneye gluteal bölgeye kesici delici alet yaralanmasıyla başvuran olgumuzu sunduk. Anahtar Kelimeler: Kesici delici alet yaralanması, gluteal bölge, ince barsak perferasyonu Penetrating sharp object injuries in the gluteal region are common. However, it is very rare that these injuries lead to perforation of the small bowel by pelvic penetration, which is generally overlooked. As penetration depth increases, there may be life-threatening injuries such as vascular injury, bowel injury and genitourinary injury depending on the localization of injury site. The case report addressed in the present research focuses on a patient who was admitted to the hospital because of a penetrating sharp object injury in the gluteal region.

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The spectrum of injuries in buttock stab wounds

Cited by 6 publications

References 12 publications

Buttock wounds: beware what lies beneath

Buttock wounds: beware what lies beneath

Penetrating gluteal injuries in North West London: a retrospective cohort study and initial management guideline

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

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