Impalement injury – presentation of two new cases

Abstract

Massive penetrating trauma by impalement is a rare form of injury. As this report presents two new cases of thoracoabdominal impalement, the description of the clinical courses of these two patients, who had both been hit by iron rods falling from a great height, is used to analyse the available literature as well. There is uniform agreement that the penetrating object needs to stay in situ until management at a tertiary trauma centre can be started. The possibility of multiple lesions with the need to be treated by different surgical specialities needs to be taken into account. Damage to cardiovascular structure is the highest risk factor for a poor outcome. However, in all other situations, qualified treatment can lead to a favourable outcome, as was seen for the two patients described in this report.