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Case Reports
. 2011 Apr;27(2):272-4.
doi: 10.4103/0970-9185.81846.

Penetrating abdominal injury in a polytrauma patient: Anaesthetic challenges faced

Thrivikrama Padur Tantry  1 , Dinesh Kadam, Pramal Shetty, Karunakara Kenjar Adappa, Bg Muralishankar, Sunil P Shenoy
Affiliations
Case Reports

Penetrating abdominal injury in a polytrauma patient: Anaesthetic challenges faced

Thrivikrama Padur Tantry et al. J Anaesthesiol Clin Pharmacol. 2011 Apr.

Abstract

Penetrating abdominal injuries are potentially life threatening due to the associated hemorrhagic shock and visceral injury. Through and through penetrating injury with polytrauma is rarely encountered. We report a case presenting with in situ projecting heavy metallic rod in a through and through penetrating abdominal injury along with foreign body in a road traffic accident. Anaesthetic management was difficult due to inability to position in supine, rapidly progressing hemorrhagic shock and hypoxia due hemopneumothorax. Two operating tables were used with adequate intervening space to accommodate the posteriorly projecting metallic rod during intubation in supine position. Intensive monitoring and resuscitation resulted in uneventful successful outcome.

Keywords: Operating table; penetrating abdominal injury; polytrauma; positioning; shock.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Penetrated object visible in anaesthetized patient. Note a) ICD tube b) Inability to support the fractured pelvis.
Figure 2
Figure 2
Penetrating foreign body and nylon bag visible through anterior abdominal wall
Figure 3
Figure 3
Rusted metallic bar with nylon bag
Figure 4
Figure 4
Operating room (OR) tables in parallel, avoiding the foreign body hinging
See this image and copyright information in PMC

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