Penetrating Stab Wound of the Gluteus-a Potentially Life-Threatening Injury

Feigenberg, Zvi; Ben-Baruch, Dan; Barak, Reuben; M, Zer

doi:10.1097/00005373-199211000-00032

Cited by 10 publications

(11 citation statements)

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“…Whereas vascular injuries in the groin area are easily detected, those in the retroperitoneum may be difficult to diagnose and the patient may not survive. 3 In one of our cases who died in the emergency room, gross bleeding was detected as a result of paracentesis, which was as the sign of injury of a major vessel.…”

Section: Discussionmentioning

confidence: 82%

“…Any associated hollow viscus or genitourinary injuries can be managed after hemorrhage has been treated or ruled out. [1][2][3][4][5] Gross rectal bleeding may be a result of rectal injury. Positive Hemoccult test may be an indicator of rectal injury.…”

Section: Discussionmentioning

confidence: 99%

“…When suspected, pyelography and cystoscopy are indicated. 1,3 Serious vascular injuries may occur to major vessels in the groin or the retroperitoneum. Whereas vascular injuries in the groin area are easily detected, those in the retroperitoneum may be difficult to diagnose and the patient may not survive.…”

Section: Discussionmentioning

confidence: 99%

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Isolated Penetrating Gluteal Injuries

Ceyran

Akçalı²,

Özcan³

et al. 2009

Perspectives in Vascular Surgery and Endovascular Therapy

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In the authors' institution, 27 patients with gluteal injuries were treated surgically during the past 17 years. All patients were males, and the mean age was 32.4 years. Most patients (89%) had stab wounds. The lesion was on the right buttock in 16 (59%) patients and on the left buttock in 11 (41%) patients. Bleeding was the most common presenting sign. The superior gluteal artery and its branches were the most commonly injured arteries (89%). Surgical procedure was arterial ligation alone in all but one case, whereas one patient underwent coil embolization. Mortality was 11% and included 1 death on arrival to the medical center and 2 intraoperative deaths. To achieve a low rate of morbidity and mortality with such injuries, careful physical examination and immediate surgical or endovascular treatment is needed.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

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Isolated Penetrating Gluteal Injuries

Ceyran

Akçalı²,

Özcan³

et al. 2009

Perspectives in Vascular Surgery and Endovascular Therapy

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“…A comprehensive review of data has not yet been provided as penetrating injury to the buttock is not a common condition accounting for 2-3% of all penetrating injuries [3,6-10]. Four previous reviews of the literature do however require additional research in terms of consistent patterns, peculiarities, and management [6-9].…”

Section: Introductionmentioning

confidence: 99%

“…Four previous reviews of the literature do however require additional research in terms of consistent patterns, peculiarities, and management [6-9]. …”

Section: Introductionmentioning

confidence: 99%

Analytical review of 664 cases of penetrating buttock trauma

Lunevičius

Schulte

2011

World J Emerg Surg

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A comprehensive review of data has not yet been provided as penetrating injury to the buttock is not a common condition accounting for 2-3% of all penetrating injuries. The aim of the study is to provide the as yet lacking analytical review of the literature on penetrating trauma to the buttock, with appraisal of characteristics, features, outcomes, and patterns of major injuries. Based on these results we will provide an algorithm. Using a set of terms we searched the databases Pub Med, EMBASE, Cochran, and CINAHL for articles published in English between 1970 and 2010. We analysed cumulative data from prospective and retrospective studies, and case reports. The literature search revealed 36 relevant articles containing data on 664 patients. There was no grade A evidence found. The injury population mostly consists of young males (95.4%) with a high proportion missile injury (75.9%). Bleeding was found to be the key problem which mostly occurs from internal injury and results in shock in 10%. Overall mortality is 2.9% with significant adverse impact of visceral or vascular injury and shock (P < 0.001). The major injury pattern significantly varies between shot and stab injury with small bowel, colon, or rectum injuries leading in shot wounds, whilst vascular injury leads in stab wounds (P < 0.01). Laparotomy was required in 26.9% of patients. Wound infection, sepsis or multiorgan failure, small bowel fistula, ileus, rebleeding, focal neurologic deficit, and urinary tract infection were the most common complications. Sharp differences in injury pattern endorse an algorithm for differential therapy of penetrating buttock trauma. In conclusion, penetrating buttock trauma should be regarded as a life-threatening injury with impact beyond the pelvis until proven otherwise.

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Penetrating injury to the buttock: an update

et al. 2014

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Clinical research on penetrating injury to the buttock is sparse and largely limited to case reports and clinical series. The purpose of this paper is to provide a detailed overview of literature of the topic and to propose a basic algorithm for management of penetrating gluteal injuries (PGI). MEDLINE, EMBASE, Cochran, and CINAHL databases were employed. Thirty-seven papers were selected and retrieved for overview from 1,021 records. PGI accounts for 2-3 % of all penetrating injuries, with a mortality rate up to 4 %. Most haemodynamically stable patients will benefit from traditional wound care and selective non-operative management. When gluteal fascia injury is confirmed or suspected, a contrast-enhanced CT-scan provides the most accurate injury diagnosis. CT-scan-based angiography and endovascular interventions radically supplement assessment and management of patients with penetrating injury to the major buttock and adjacent extra-buttock arteries. Immediate life-saving damage-control surgery is indicated for patients with hypovolemic shock and signs of internal bleeding. A universal basic management algorithm is proposed. This overview shows that penetrating injury to the buttock should be regarded as a potential life-threatening injury, and therefore, patients with such injuries should be managed in trauma centres equipped with hybrid operating theatres for emergency endovascular and open surgery for multidisciplinary teams operating 24/7.

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Penetrating Stab Wound of the Gluteus-a Potentially Life-Threatening Injury

Cited by 10 publications

References 0 publications

Isolated Penetrating Gluteal Injuries

Isolated Penetrating Gluteal Injuries

Analytical review of 664 cases of penetrating buttock trauma

Penetrating injury to the buttock: an update

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