Citation

Djelti A, Jneid H. Int. J. Surg. Case Rep. 2020; 68: 270-272.

Affiliation

Department of General Surgery, C.H.U. Lamine Debaghine, Bab El Oued, Algiers, Algeria.

Copyright

(Copyright © 2020, Elsevier Publishing)

DOI

10.1016/j.ijscr.2020.02.064

PMID

32220795

Abstract

INTRODUCTION: Abdominal impalement by spear is fortunately exceptional. In the literature, only twenty cases have been so far reported. In most cases, transfixing wounds result in serious visceral and/or vascular lesions with a high risk of mortality. Those cases need careful planning and a preoperative order to properly control the spring harpoon during extraction. The extraction of the spear is a delicate process requiring a thorough study of each case to avoid further damage to the patient. This case is written following the SCARE scale for case report writing. PRESENTATION OF CASE: We report the case of a 39-year patient, admitted to the hospital only after 13 h after the accident. No visceral or vascular lesion was observed, except minimal liver damage to the 3rd liver segment. The liver was almost spared in only the third segment was lightly touched and regarding the vascular and visceral apparatus, no serious lesions were highlighted.

DISCUSSION: The marking problem we encountered with this patient was that the harpoon ended by a mobile spring beard, which led to a profound lesion and also, to a certain difficulty to get access to it. Also, because of the aorta wound, the surgical approach was chosen, allowing a good exposure of the object.

CONCLUSION: When it comes to abdominal impalement, following the rules of transporting and mobilizing the patient, using the infectious risk prevention and knowing the importance of the initial assessment of damage aided by radiology, can allow better management of the situation.

Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Language: en

Keywords

Abdominal impalement; Harpoon gun; Hepatic injury; Survival; Transfixing injury