Rectal Impalement Injury: from Cruelty to Salvage Endeavour

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Rectal Impalement Injury: from Cruelty to Salvage Endeavour

C. Lupaşcu, V. Fotea, P. Sârbu, D. Andronic
Clinical case, no. 1, 2015
Massive penetrating trauma by rectal impalement is a very rareform of injury, complicated and potentially lethal. It is evenrarer for such injury to result in pelvic, abdominal and thoracicinternal damages. We report the case of a 62 year-old man whowas admitted in emergency after an aggression with a sharpwooden stake inserted forcibly into his rectum. Clinicalexamination revealed the blunt extremity of the stake outsidethe anus and the prominent sharp end reaching his rightsupraclavicular fossa. Radiographic examination showed thestake extending from the rectum to the right side of the neck.Surgery disclosed penetration through the rectum, retroperitoneum,large bowel mesentery, liver, diaphragm, right lungand right 2nd rib. The patient survived following managementby a multidisciplinary surgical team. As similar reported casesare scarce, knowledge of the management of the few cases thathave been successfully treated is likely to prepare theemergency teams to act rationally and efficiently in suchexceptionally circumstances.