Abdominopelvic impalement with tree branch causing major vascular injury

Q4 Medicine

Trauma Case Reports Pub Date : 2025-04-15 DOI:10.1016/j.tcr.2025.101181

Stevan Fairburn , Adam Sturdivant , James Hwang , John B. Holcomb , Jeffrey D. Kerby , Janet Julson , Jon Winkler , W. Preston Hewgley

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引用次数: 0

Abstract

This case report describes the management of a 45-year-old female who sustained an abdominopelvic impalement injury from a tree branch following a motor vehicle accident. The branch impaled the abdominal wall at the left lower quadrant and exited the patient's left posterior pelvis. The impaled object prevented supine positioning and disrupted the formulaic primary and secondary survey. While tempting to remove such an impaled object, surgical fundamentals dictate they be left in situ until surgical intervention. In this scenario, tamponade from the impaled object prevented catastrophic hemorrhage until vascular control was established in the operating room. The patient's physiology remained appropriate to begin reconstructive efforts at the index operation, minimizing the number of operations and ensuring the patient's long-term functionality. Management of this impaled object provides an example of how to manipulate the surrounding environment to optimize surgical approach when external factors prevent standard positioning.

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伴树枝的腹盂穿刺造成大血管损伤

本病例报告描述了一名45岁女性的处理，她在机动车事故后从树枝上刺伤了腹部骨盆。分支刺穿左侧下腹腹壁，从患者左侧后骨盆穿出。刺穿的物体妨碍了仰卧位定位，扰乱了公式化的初级和次级测量。虽然很想移除这样的刺穿物体，但外科基本原理要求它们留在原位直到手术干预。在这种情况下，通过穿刺物填塞防止了灾难性出血，直到在手术室建立血管控制。患者的生理状况保持适宜，可以在索引手术中开始重建工作，减少手术次数并确保患者的长期功能。当外部因素妨碍标准定位时，如何操纵周围环境以优化手术入路提供了一个例子。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Trauma Case Reports Medicine-Emergency Medicine

CiteScore

0.60

自引率

0.00%

发文量

131

审稿时长

26 weeks

期刊介绍： Trauma Case Reports is the only open access, online journal dedicated to the publication of case reports in all aspects of trauma care and accident surgery. Case reports on all aspects of trauma management, surgical procedures for all tissues, resuscitation, anaesthesia and trauma and tissue healing will be considered for publication by the international editorial team and will be subject to peer review. Bringing together these cases from an international authorship will shed light on surgical problems and help in their effective resolution.