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Rectum perforation after broomstick impalement in a 17-year-old: case report and review

Michael Boettcher1, Ilias Kanellos-Becker, Katharina Wenke

  • 1Department of Pediatric Surgery, University Children's Hospital Altona, UKE-Medical School, Hamburg, Germany. michboettcher@gmail.com

Pediatric Emergency Care
|April 6, 2013
PubMed

Insights

Pediatric impalement injuries, though rare, can be life-threatening. Prompt diagnosis requires thorough evaluation, even without visible trauma, to manage these critical injuries effectively.

Area of Science:

  • Pediatric Surgery
  • Trauma Surgery
  • Emergency Medicine

Background:

  • Impalement injuries are rare in children.
  • Physicians may face challenges in recognizing and managing these injuries due to their uncommon nature.
  • Clinical presentation can be deceptively benign, masking potentially severe outcomes.

Observation:

  • A rare case of rectal perforation following transanal broomstick impalement in a child is presented.
  • The injury exhibited minimal external clinical findings, highlighting the challenge in initial assessment.
  • This case underscores the potential for severe internal damage despite innocuous external signs.

Findings:

  • Impalement injuries, particularly rectal perforations, can present with subtle or absent external signs of trauma.
  • The severity of internal injury may not correlate with the visible external evidence.
  • A high index of suspicion and a systematic diagnostic approach are crucial.

Implications:

  • Healthcare providers must maintain a low threshold for investigating suspected impalement injuries in pediatric patients.
  • Thorough history taking and physical examination, including assessment for internal injury even without perineal trauma, are essential.
  • A well-organized workup is critical for timely diagnosis and appropriate management of pediatric impalement injuries to prevent severe complications.

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