Impalement injury by glass shard with delayed colonic perforation

Abstract

A 66-year-old man experienced a traumatic injury after a fall on top of a glass tea table, which caused some superficial lacerations all around the body. He was examined in the emergency room by a physician. The physician could not feel any foreign body upon wound exploration and sutured the laceration. Fourteen months after the injury, he developed progressive abdominal pain. On emergency room and abdominal x-ray showed a foreign body, which a CT scan revealed as an intraabdominal glass shard. The glass presumably impaled his abdominal wall as a result of his previous traumatic injury. The patient underwent laparotomy, which revealed a large glass (16x1cm) perforating the transverse colon. It was extracted and the perforation closed with a lineal stapler. There was no need of bowel resection and the patient was discharged home nine days after the intervention.

Discovery of a Glass Splinter in the Abdominal Cavity After an Old Impalement Injury: A Case Report and Literature Review

“…In the literature, we only found 4 other cases of long-term presence of a piece of glass in the peritoneal cavity with delayed presentation after an impalement injury [8][9][10][11] (Table 1). All described cases had a common mechanism of injury -impact on a stationary object (type I by clinical classification of impalement injury) [12].…”

“…In 2 of the 3 patients, delayed presentation of bowel damage occurred and resection was necessary [9,11]. In 1 patient, delayed closure of a colonic perforation with a linear stapler without resection was performed [10] and the late results were good.…”

Glass table tops: An unusual source of lethal domestic injury

“…They all had occult glass shards removed that measured 19, 16 and 8.5 cm in length, respectively. [21][22][23] Thus, glass tabletops represent a rare but ongoing cause of death in domestic situations, and account for a much larger number of non-lethal injuries, particularly in children. These tables should not be used as a substitute for chairs, particularly in overweight individuals, as this provides yet another circumstance where obesity increases the risk of injury.…”

Perforación de colon secundaria a empalamiento autoinfligido: a propósito de un caso

“…Idealmente se debe cortar el objeto para facilitar la movilización o posicionamiento. Todo objeto empalado debe considerarse altamente contaminado, y por lo tanto, debe administrarse cobertura antibiótica de amplio espectro y antitetánica 9 . De forma esquemática, el abordaje del empalamiento puede realizarse según diversas clasificaciones de lesiones anorrectales.…”