Impalement Injury Research Articles

Surgical Treatment of Impalement Injury to the Right Lower Eyelid and Eye Following Explosion of Sharpening Stone

Surgical Treatment of Impalement Injury to the Right Lower Eyelid and Eye Following Explosion of Sharpening Stone

Complex-Type Foreign Body Penetrating Injuries of the Craniofacial Region and Surgical Management: A Report of Three Cases.

Craniofacial penetrating injuries are not a rare sight in the career of oral and maxillofacial surgeons and trainees, but bizarre craniomaxillofacial sharp injuries caused by peculiar foreign bodies to the head and neck region, complicating and obscuring the vital structures, are seldomfound. Foreign bodies such as lunch boxes, wooden branches or twigs are peculiarly associated with penetrating/perforating craniofacial severe impaled injuries with dramatic consequences. Three cases are reported, with elaborate descriptions of the site, kind, and severity of the injuries. Cases 1 and 3, wooden impalement injuries into the neck region and sensitive orbital region, respectively, necessitating immediate surgical retrieval as in both cases. In case 2, 4-year old sustained an injury with a sharp rim of the lunch box, obscuring the entire craniofacial region and impeding the primary care and assessment.Cases represent the peculiarity of the injuries caused by unusual foreign bodies and how their uniqueness demanded a different surgical intervention.The need for a multidisciplinary approach is crucial to managing these injuries in areas with a high degree of specialization overlap, such as the craniofacial region. We give an overview of the diagnosis and treatment of penetrating foreign body trauma encountered in our department. Every foreign bodypenetrating trauma demands a formulation of a different surgical plan and stands as a challenge for the treating surgeons. Adequate radiology knowledge, detection, vigilant clinical assessment, and tension-free closure are a few of the important aspects for the ideal management of penetrating foreign body trauma.

A Case of Impalement Injury from the Pharynx into the Carotid Artery Space

A Case of Impalement Injury from the Pharynx into the Carotid Artery Space

Management of 52 small bowel perforations following gunshot injury: A case report

Abstract Small bowel injury is one of the most common abdominal injuries following penetrating injuries and is usually secondary to gunshot, stab, or impalement injuries to the abdomen. We report a case of shotgun injury to the abdomen in a hemodynamically stable man. He had an emergency exploratory laparotomy, during which 52 small bowel perforations and 1 transverse colon perforation were found. He was managed by damage control surgery involving a temporary nonclosure of the anterior abdominal wall with resuscitation and a second look laparotomy after 48 h.

Orbitoethmoidal foreign body through traumatic penetrating orbital injury

Foreign bodies in the nasal cavity, paranasal sinuses, and orbit are commonly related to high-velocity maxillofacial injuries. Cases of foreign bodies in paranasal sinuses are very rare. They may present with non-specific symptoms which make them easily neglected during history taking and clinical assessment. High clinical suspicion and radiological assessments are essential in patients with high-velocity insult to rule out the possibility of impalement injury. The course of management is determined by the location and type of foreign body. We share a rare case of metallic foreign bodies in the orbitoethmoidal region which took a combined surgical and conservative course of treatment involving a multidisciplinary team.

Thoraco-Abdominal Split by a Metallic Rod: A Case Report

Introduction: Impalement wounds are defined by foreign objects usually steel bars or a wooden object, piercing a body cavity in part or from one end to another and always remaining in place. Thoraco- abdominal impalements are cases of rare trauma in our exercise context. We report a case of thoraco-abdominal impalement in an 11-year-old patient as well as our therapeutic attitude in our exercise context. Observation: this is an 11-year-old student, with no medical and surgical history, received in emergency for thoraco-abdominal trauma following a play activity in the family home. Discussion: Penetrating thoraco-abdominal wounds are most often caused by gunshot wounds. Impalement is a potentially serious lesion that can be immediately life-threatening and depends on the organs affected. Our case study concerns a patient victim of a domestic accident following a playful activity within the family home. The injuring agent was a concrete rod positioned within the home without any security measures and which was used to tie up sheep intended for domestic breeding. Management of impalements must comply with rules so as not to aggravate the lesions. Conclusion: Thoracoabdominal impalement injuries are potentially serious and can be life-threatening. Its management is a challenge in countries with limited resources like ours. Good coordination of medico-surgical care allowed optimal management of the patient.

Abdominal Trauma by Impalement. Clinical case.

Introduction: Impalement injury is one of the most spectacular and potentially dramatic rare forms of penetrating trauma. [2,3] In many cases, the impaled patient dies at the scene.[3] The patient who manages to reach the hospital alive and is hemodynamically stable has a good chance of overcoming a traumatic event. However, the non-removal of a foreign object represents the cornerstone of initial treatment, as possible vascular lesions remain compressed by the object in situ, thus avoiding irrepressible hemorrhages. Clinical case: A 32-year-old male was brought in by a paramedic after suffering electrical burns to the right thoracic limb and right pelvic limb that caused a fall from a power pole with subsequent penetrating abdominal trauma due to impalement. He denies antecedents of importance for the current condition. Upon arrival, he was hemodynamically stable, with the presence of a first-degree electrical burn in the right hand and forearm and the right thigh, as well as a metallic rod passing through the abdomen from the left groin to the right flank, for which it was decided to perform Exploratory Laparotomy who reported the following findings: Intestinal perforation of more than 50% of the lumen at jejunum level, side-to-side anastomosis was performed. During his stay on the floor of General Surgery, he had a torpid post-surgical evolution, intolerance to the oral route, abdominal distension, absence of gas channeling, and symptoms of intestinal obstruction, for which it was decided to perform a new Exploratory Laparotomy, finding intestinal stenosis at the level of the previous anastomosis was dismantled and reconstructed in side by side, on this occasion with favorable evolution and he was discharged due to improvement after 14 days of hospital stay. Discussion: Prehospital emergency medicine (PHEM) offers unique and challenging perspectives to orthodox emergency medicine. Impalements are extremely rare and often require a multidisciplinary team approach in the prehospital setting. Most cases of impalements are fatal at the scene. Patients surviving the initial trauma and arriving at the hospital alive, usually make a good recovery with multidisciplinary team management underpinning the importance of meticulous prehospital care in transporting patients with impalements safely. This case highlights the role of PHEM clinicians as experts in clinical knowledge, decision-making, leadership, team working skills, and improvisations.

An Unusual/Rare Case of Toothbrush Impalement Injury in Floor of Mouth.

Foreign bodies of the aero-digestive tract are commonly seen emergencies in ENT practice. Young children often present with accidental ingestion of foreign bodies like coins and battery cells. However penetrative foreign bodies of the oral cavity and the aerodigestive tract are relatively rare. They can mostly me managed conservatively, however, they may develop life threatening complications like deep neck space infections and major arterial injury in few cases. After doing extensive literature search, we could find only 1 similar case with impaled toothbrush in the floor of mouth. Therefore, we are reporting only the second case of a child who presented with impalement of toothbrush in the floor of mouth. The toothbrush was surgically removed under general anaesthesia and post-operative period was uneventful. Take home message is to not forcefully pull out the foreign body and seek otorhinolaryngological intervention at the earliest.

Eight Month-Old-Infant Impaled by Toothbrush Through the Hard Palate.

Impalement of children with foreign bodies is not uncommon. A variety of foreign bodies and mechanisms of injuries have been described. Infant tissues are more vulnerable to injuries and often penetrating traumas are very dangerous. An 8-month-old infant was referred to our department with a major impalement injury of his hard palate by a toothbrush. The integrity of the orbit was in question due to the high proximity of the foreign body to the lamina papyracea. A well-structured algorithm was followed to secure the best interests of the child. Our approach minimizes the risk of complications by taking into account every single parameter. After the removal of the foreign body, a careful reconstruction with meticulous nasendoscopy was held to restore the hard palate integrity and to check the orbit inner wall. According to the literature, toothbrushes seem to be the most common medium of impalement trauma. Parents should be educated that their offspring are at great risk when holding or sucking objects while playing.

Orbital impalement injury in childhood: the importance of imaging and interdisciplinary treatment

Orbital impalement injury in childhood: the importance of imaging and interdisciplinary treatment

Uncommon rectal impalement injury with an unexpected intraabdominal trauma

Rectal penetrating injuries are a very rare and potentially lethal form of trauma in children. We report the case of a rectal impalement injury (RII) in a 3-year-old female patient after an almost unbelievable accident at home. Laparotomy revealed a traumatic rectal wall perforation. Initially, we had a high suspicion of child abuse. Later, the child was readmitted with vomiting and elevated inflammation parameters. Diagnostics including MRI showed an intrahepatic foreign body abscess, which was treated laparoscopically. We found a piece of diaper residue consistent with the trauma mechanism reported by the parents. With this case report we would like to draw attention to a very unusual and almost incredible injury, its sequelae and challenges.

Intraoral Impalement Injury with Electric Toothbrush Head to the Infratemporal Fossa: A Case Report

Study Design Case Report. Objective To discuss the case of a 55-year-old man who complained of swelling and pain in the left cheek. Methods Computed tomographic images showed a shadow of retained electric toothbrush head in the left infratemporal fossa, heterotopic free air, and abscess formation in the masticatory space. Foreign body removal and surgical drainage were performed under general anesthesia. Result The patient was discharged 6 days postoperatively. Conclusion Computed tomography should invariably be performed on patients with intraoral impalement injury.

Posttraumatic pneumonectomy and management of severely contaminated pleural space.

Posttraumatic pneumonectomy and management of severely contaminated pleural space.

Accidental abdominal impalement: 2 rare presentations

Impalement injuries to the abdomen are a type of penetrating injury after stab wounds and gunshot wounds. Exploration is routinely required because often the nature and extent of the injury cannot be diagnosed preo peratively. Extrication of the impaled object in the operating room under controlled conditions is important. A multidisciplinary approach is often required.

The Management of Perineal Trauma in Children.

Aims:This study aimed to evaluate the outcome of perineal trauma in children and to a define protocol for their management.Methods:It is a retrospective study of children who presented with perineal injury between August 2012 and December 2020. The patients were classified into three groups: Group-1 included children with perineal and genitourinary injuries; Group-2 included patients with perineal and anorectal injuries; and Group-3 included patients with perineal, genitourinary, and anorectal injuries. All patients underwent primary repair. Those with full-thickness anorectal injury underwent an additional covering colostomy, while urethral disruption was initially managed by a diverting suprapubic cystostomy (SPC).Results:A total of 41 patients were studied. Impalement injury (n = 11; 27%) and sexual abuse (n = 11; 27%) were the most common mechanisms of injury. Twenty (49%) patients had anorectal injuries with 10 (24%) each of partial-thickness and full-thickness injury. There were 24 (59%) genital injuries and five (12%) urethral injuries. One patient each developed anal and vaginal stenosis, both were managed with dilatation. One patient developed a rectovaginal fistula repaired surgically at a later date.Conclusion:Perineal injuries with resultant anorectal or genital damage require a careful primary survey. Following stabilization, an examination under anesthesia as a set protocol will help determine the treatment strategy. A colostomy is essential in the acute management of severe anorectal injuries to reduce local complications and preserve continence. Urethral injuries may warrant an initial diverting SPC in selected cases.

Surgical management of traumatic diaphragmatic rupture: ten-year experience in a Teaching Hospital in Ghana.

IntroductionDiaphragmatic injuries may be associated with thoracoabdominal blunt or penetrating traumas. The diagnosis is often delayed, despite the availability of several medical imaging modalities. The surgical management remains controversial, in terms of the choice of surgical approach and the surgical repair technique.AimTo evaluate the surgical management experience of traumatic diaphragmatic rupture in our institution over a ten-year period in the local setting of a tertiary hospital in Ghana.Material and methodsA retrospective review of the medical records of patients who had undergone surgery for traumatic diaphragmatic rupture.ResultsA total of 35 cases of diaphragmatic rupture were seen from thoracoabdominal injuries. There were 29 (82.86%) males. The mean age was 36.25 ±12.98 years with a range of 16–65 years. There were 3 cases of right diaphragmatic rupture and 32 cases of left diaphragmatic rupture. Penetrating chest injury caused 18 (51%) of the ruptures. The leading cause of injury was road traffic accident, which constituted 48.57%, closely followed by stab (25.71%), gunshot injuries (14.29%) and impalement injury (11.48%). Seventeen (49%) patients had their diaphragmatic ruptures repaired via laparotomy and the remaining 18 (51%) via thoracotomy. The commonest herniated organ was the stomach. One patient died in theatre from cardiac arrest after failed intubation.ConclusionsSurgery is the treatment of choice in traumatic diaphragmatic rupture and it is repaired via laparotomy or thoracotomy based on the presence or absence of concomitant abdominal injury and the presence or absence of a cardiothoracic surgeon.

A case of impalement injury caused by an object penetrating from the face to the intracranium

A case of impalement injury caused by an object penetrating from the face to the intracranium

A Case of Chest Impalement Injury and Lung Injury Caused by the Horn of a Bull

A Case of Chest Impalement Injury and Lung Injury Caused by the Horn of a Bull

Pre-Hospital and In-Hospital Management of an Abdominal Impalement Injury Caused by a Tree Branch

In South Korea, most patients who visit trauma centers with abdominal injuries have blunt trauma, and penetrating injuries are relatively rare. In extremely rare cases, some patients are admitted with a long object penetrating their abdomen, and these injuries are referred to as abdominal impalement injuries. Most cases of impalement injuries lead to fatal bleeding, and patients often die at the scene of the accident. However, patients who survive until reaching the hospital can have a good prognosis with optimal treatment. A 68-year-old female patient was admitted to the trauma center with a 4-cm-thick tree branch impaling her abdomen. The patient was transported by a medical helicopter and had stable vital signs at admission. The branch sticking out of the abdomen was quite long; thus, we carefully cut the branch with an electric saw to perform computed tomography (CT). CT revealed no signs of major blood vessel injury, but intestinal perforation was observed. During laparotomy, the tree branch was removed after confirming that there were no vascular injuries, and enterostomy was performed because of extensive intestinal injury. After treating other injuries, the patient was discharged without any complications except colostomy. Abdominal impalement injuries are treated using various approaches depending on the injury mechanism and injured region. However, the most important consideration is that the impaled object should not be removed during transportation and resuscitation. Instead, it should only be removed after checking for injuries to blood vessels during laparotomy in an environment where injury control is possible.

IMPALEMENT OF AN UNUSUAL FOREIGN BODY IN THE LEG – A CASE REPORT

Foreign body penetration is not uncommon and may be glass, shrapnel, needles, etc. and may occur in almost any part of the body. Impalement injury is when a blunt force causes a long object to penetrate a body part resulting in retention of the object in situ. The management following foreign body penetration includes tetanus prophylaxis, parenteral antibiotic cover and removal of the foreign body in the theatre with exploration for neurovascular injury, thorough debridement and repair of any damaged tissue. Here, we report a case of an industrial foreign body that impaled a middle aged male while at work in the left leg which was carefully removed under anaesthesia with no post-operative complications.