TWO CASES OF IMPALEMENT INJURY TO THE RECTUM

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 59; no. 4; pp. 1020 - 1023
• Main Authors: SAHARA, Hiroyuki, AKIYAMA, Takayoshi, TOMITA, Fujio, SAITO, Hitoshi, KITA, Ichiro, TAKASHIMA, Shigeki
• Format: Journal Article
• Language: English
• Published: Japan Surgical Association 1998
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.59.1020

Impalement injury is a rare course of blunt injury. We experienced two cases of impalement injury to the rectum. Case 1: When a 63-year-old woman fallen on her gluteal region, a bamboo stump penetrated her rectum via the anus. Abdominal X-ray examination disclosed free air bilaterally beneath the diaphragm. The injury reached the peritoneal cavity, and she was diagnosed with panperitonitis. Case 2: When an 8-year-old boy jumped from a height of 2 meters, his bottom penetrated by an iron stake about 20cm in longth. Fistelography reveaeld that the injury extended through his rectum, but did not reach the periotneal cavity. Both patients underwent emergency operations, in which the rectal injury was reparied and a loop colostomy was formed with sigmoid colon. The postoperative clinical course was unremarkable in both cases, and the loop colostomies were closed 3 and 2months after operations, respectively. Rapid diagnosis of injury to the internal organs is most important in impalement injury, and clostomy and drainage from the basis of successful treatment of impalement injury of the rectum.