Impalement injury of the perineum with an iron rod with a minimal injury: A near miss: A case report. (March 2021)

• Record Type: Journal Article
• Authors: Shrestha, Bibek Man; Koirala, Dinesh Prasad; Shrestha, Suraj; Kharel, Sanjeev; Lamichane, Shankar Raj; Dahal, Geha Raj
• Is Part Of: International journal of surgery case reports. Volume 80(2021)
• Publication Date: 2021-03
• Subjects: Emergency -- Impalement -- Perineum -- Trauma -- Case report; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2021.105645
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Perineal impalement injuries are often fatal. We report a perineal impalement injury by an iron rod piercing the perineum with minimal external and internal injuries. Urgent laparotomy to manage all the potential injuries along with effective resuscitation and prehospital care are critical. Abstract: Introduction and importance: Penetrating perineal injury in children is uncommon. However, the injury is serious and life-threatening with significant morbidity and mortality. Case presentation: We report an unusual case of a 13-year-old boy with an accidental perineal impalement injury by an iron rod, which pierced through the perineum and exited through the left loin, however with minimal external and internal injuries. Clinical discussion: Multiple vital organs in the pelvic space are vulnerable to damage in perineal impalement injury. Vital organ injury, amount of blood loss, and effectiveness of the resuscitation determine the outcome of an impalement injury. Urgent laparotomy forms the cornerstone in management as all the potential injuries can be identified and managed immediately. Conclusion: Effective resuscitation and accurate assessment of the associated injuries along with proper pre-hospital care with a multidisciplinary approach is crucial for the survival and optimum outcome of the victim.