Transperineal abdomino-thoracic impalement

BMJ Case Rep. 2025 Apr 29;18(4):e265224. doi: 10.1136/bcr-2025-265224.

Abstract

Transperineal abdomino-thoracic impalement is a rare and complex penetrating injury that can present a significant challenge to surgeons worldwide. Due to its rarity, there are no established treatment guidelines for such scenarios. Management typically follows Advanced Trauma Life Support principles, emphasising the importance of a multidisciplinary approach. Detailed knowledge of the intricate anatomical relationships of the perineum and the catastrophic nature of such injuries is essential. To date, only eight cases of perineal impalement traversing the abdomen and thoracic cavity have been documented in the literature. Here, we describe the case of a male in his twenties who survived a transperineal abdomino-thoracic impalement with minimal morbidity, underscoring the importance of adhering to established principles in the management of impalement injuries.

Keywords: Accidents, injuries; General surgery; Trauma.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Injuries* / diagnostic imaging
  • Abdominal Injuries* / surgery
  • Adult
  • Humans
  • Male
  • Perineum* / injuries
  • Perineum* / surgery
  • Thoracic Injuries* / diagnostic imaging
  • Thoracic Injuries* / surgery
  • Wounds, Penetrating* / diagnostic imaging
  • Wounds, Penetrating* / surgery