A rare case of a transabdominal impalement after a fall from a ladder

Abstract

Introduction: Impalement injuries are caused by objects that penetrate and remain inside the human body. They are rare and often lead to complex surgical problems, demanding immediate measures and intensive care.

Presentation of case: We report a case of a 39 year old male who presented in our emergency department with a history of fall from a 3m high ladder, landing on a wooden stick that penetrated the patient from his left lumbar region, leading to a trans-abdominal impalement injury.

Discussion: Nowadays impalement injuries although rare, demonstrate a challenging presentation for emergency providers. Their complexity often raises concerns about the proper surgical approach and postoperative management. In many cases, they may cause severe morbidity or even be lethal.

Conclusion: The article describes a case of a transabdominal impalement injury and pinpoints the strategies followed regarding the prehospital care, as well as the intra- and postoperative management.

Keywords: Abdominal trauma; Case report; Impalement injuries; Surgical approach.

Fig. 1

shows the penetrating wooden stick.

Fig. 2

shows the penetrating stick entering the patient’s left lumbar region.

Fig. 3

shows the tip of the stick found subcutaneously with no visible exit wound.

Fig. 4

axial image that shows the object impaled traversing the tail of the pancreas as revealed by the CT.

Fig. 5

intraoperative picture of the injury at the posterior wall of the stomach.