An unusual vaginal injury in a young primigravida patient: A rare case report

INTRODUCTION: Assault with iron made belan causing penetration of it into vagina and perforation of posterior fornix is extremely rare. The commonly used weapon in assault are knife, wood, iron stick, wire, bomb or gun and most commonly affected body parts are cheeck, throat, back, abdomen, chest wall and extremities. PRESENTATION OF CASE: We report a case of iron made belan penetrated into vagina with posterior fornix perforation and mesenteric tear in a 30 years old lady with history of pregnancy of 14 weeks. She was haemodynamically unstable at the time of presentation. She was treated with advanced trauma life support Protocol (ATLS), taken to operation room where iron made belan was removed with repair of posterior fornix and mesentery was done. DISCUSSION: Assault to genital organ in female is not uncommon. In present case the offender used the metallic iron made belan for assault which is the house hold material in India. In such situation high degree of suspicion and diagnostic modality are helpful to save the golden hour of patient and save the life of patients. General principles of trauma management is really very helpful to save the life threatening conditions. Urgent exploratory laparotomy with control of bleeding and repair of damaged structures are the cornerstone steps to manage such cases. CONCLUSION: Assault with iron made belan and its penetration inside vagina is extremely rare mode of injury. Timely intervention, concept of ATLS and definitive surgical interventions are the key steps in managing such patient.