Surgical Retrieval of an Impaled Tapestry Needle from the True Pelvic Cavity of a Child-An Unusual Case Report

INTRODUCTION: Impalement injuries of pelvis have been reported in children but are uncommon. Impalement could be associated with injuries to deep organs, wound contamination, crush injuries, and in certain instances, can even be fatal. CASE REPORT: We present a bizarre case of a 2-year-old female child who presented to us with a tapestry needle embedded in the true pelvic cavity after a history of fall on the buttock while playing at home. The impaled needle was eventually successfully extracted surgically using the modified Stoppa’s approach and the post-operative period was uneventful. We also briefly review the literature surrounding such unusual injuries and discuss tips and tricks regarding the surgical technique in such cases. CONCLUSIONS: In impalement injuries, adequate analgesia, tetanus prophylaxis, antibiotics, and immobilization must be given initially followed by meticulous pre-operative planning in the form of radiographs and computed tomography(CT) scans. Minimally invasive CT-guided extraction of needle can be attempted by an experienced interventional radiologist when there is no significant risk of damaging neighboring vital organs or neurovascular structures. The surgical approach if an open approachis decided must be chosen wisely; backup may be needed from an abdominal surgeon, urologist, or gynecologist in certain cases.