Inferior vena caval injury following self-inflicted abdominal stab wound

A rare case of attempted suicidal abdominal stabbing using a shoemaker's piercing awl is reported. The patient presented with the weapon still in place. On emergency exploration, injury to the inferior vena cava and the inferior mesenteric artery were found. The case highlights the fact that major vascular injury may be present in patients of abdominal stabs with retained weapons inspite of their haemodynamic stability. It also illustrates the importance of manipulating retained weapons only after complete exposure with adequate preparation for a vascular procedure.