Swordfish bill injury involving abdomen and vertebral column: case report and review

Abstract

Background: Penetrating injuries of the abdomen and spinal canal that involve organic material of animal origin are extremely rare and derive from domestic and wild animal attacks or fish attacks.

Case presentation: In this case report we present the unique, as far as the literature is concerned, unprovoked woman's injury to the abdomen by a swordfish. There are only four cases of swordfish attacks on humans in the literature - one resulted to thoracic trauma, two to head trauma and one to knee trauma, one of which was fatal - none of which were unprovoked. Three victims were professional or amateur fishermen whereas in the last reported case the victim was a bather as in our case. Our case is the only case where organic debris of animal's origin remained in the spinal canal after penetrating trauma.

Conclusions: Although much has been written about the management of penetrating abdominal and spinal cord trauma, controversy remains about the optimal management. Moreover, there is little experience in the management of patients with such spinal injuries, due to the fact that such cases are extremely rare. In this report we focus on the patient's treatment with regard to abdominal and spinal trauma and present a review of the literature.

Figure 1

Abdominal computed tomography scan on admission, demonstrating a penetrating foreign body.

Figure 2

CT reconstruction image demonstrating the tip of the swordfish bill lodged within the spinal canal.

Figure 3

CT reconstruction image demonstrating the tip of the swordfish bill lodged within the spinal canal.

Figure 4

MRI scan of the lumbar region that indicates a foreign body penetrating the body of the L2 and the spinal canal.

Figure 5

MRI scan of lumbar region which indicates L2 inflammation and arachnoiditis of some tabular roots.

Figure 6

The fragment (swordfish bill tip) removed.