Management of chest impalement injury

Bergaminelli, Carlo; Salvi, Rosario; Mattiacci, Dario Maria; Messina, Giovanni; Cicalese, Marcellino; Curcio, Carlo; Buono, Salvatore; Corcione, Antonio; Rispoli, Marco

doi:10.1016/j.ijscr.2019.07.043

Cited by 4 publications

(2 citation statements)

References 4 publications

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“…Impalement injuries are defined as penetrating injuries involving large foreign bodies impaling the human body. The high-energy impact of these traumas causes extensive local tissue destruction with elements of both blunt and penetrating injury [5] . Few cases have been reported of those who reach the emergency department owing to the small number of survivors [1] .…”

Section: Discussionmentioning

confidence: 99%

A case of cardiac impalement injury with severe shock treated surgically after diagnosis using computed tomography and managed via extracorporeal membrane oxygenation in the hybrid emergency room

Hara

Suga

Yokoyama

et al. 2022

Trauma Case Reports

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Section: Discussionmentioning

confidence: 99%

A case of cardiac impalement injury with severe shock treated surgically after diagnosis using computed tomography and managed via extracorporeal membrane oxygenation in the hybrid emergency room

Hara

Suga

Yokoyama

et al. 2022

Trauma Case Reports

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“…Impalement injuries, which occur mostly due to traffic accidents, falls, homicide, and accidents at construction sites, are classified as a type of penetrating injury, but their mechanism involves both blunt and penetrating injuries. Thus, extensive tissue, vascular, and deep organ injuries and foreign body contamination can occur [3][4][5][6][7]. In particular, an impalement injury of the torso, such as the abdomen, can be fatal, as it can damage major vessels, such as the aorta and inferior vena cava, and solid organs and hollow viscus organs.…”

Section: Discussionmentioning

confidence: 99%

Pre-Hospital and In-Hospital Management of an Abdominal Impalement Injury Caused by a Tree Branch

et al. 2021

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In South Korea, most patients who visit trauma centers with abdominal injuries have blunt trauma, and penetrating injuries are relatively rare. In extremely rare cases, some patients are admitted with a long object penetrating their abdomen, and these injuries are referred to as abdominal impalement injuries. Most cases of impalement injuries lead to fatal bleeding, and patients often die at the scene of the accident. However, patients who survive until reaching the hospital can have a good prognosis with optimal treatment. A 68-year-old female patient was admitted to the trauma center with a 4-cm-thick tree branch impaling her abdomen. The patient was transported by a medical helicopter and had stable vital signs at admission. The branch sticking out of the abdomen was quite long; thus, we carefully cut the branch with an electric saw to perform computed tomography (CT). CT revealed no signs of major blood vessel injury, but intestinal perforation was observed. During laparotomy, the tree branch was removed after confirming that there were no vascular injuries, and enterostomy was performed because of extensive intestinal injury. After treating other injuries, the patient was discharged without any complications except colostomy. Abdominal impalement injuries are treated using various approaches depending on the injury mechanism and injured region. However, the most important consideration is that the impaled object should not be removed during transportation and resuscitation. Instead, it should only be removed after checking for injuries to blood vessels during laparotomy in an environment where injury control is possible.

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