Multiple impalement injuries of the torso with two metal bars: A case report

INTRODUCTION AND IMPORTANCE: Impalement injury is a type of penetrating trauma that is rarely mentioned and studied in the medical literature. Patients who could show up at the emergency room are those who got an isolated stab wound in their extremities. The torso injuries are usually fatal in the scene of the accident. We report two metal bars that impaled in the pelvic, back, abdomen and thorax of the patient who was admitted in OR directly. CASE PRESENTATION: A 20 year-old construction worker fell down on two metal bars. At the scene; we cut the metallic bars off the column and then we transported the patient keeping the foreign bodys in situ. Right sided tube thoracostomy was done, and then the patient had an exploratory laparotomy detecting vital organs that had be injured before taking out the 2 bars. The technique steps focused mainly on checking heart, lung, liver, kidney, main vessels and spinal cord; respectively. CLINICAL DISCUSSION: Third world countries should provide a safety environment for construction workers. Surgeons should be able to make a decision to operate the patient immediately without time wasting by unnecessary investigation. This investigation could be useful later intra-operatively. CONCLUSION: The safety of workers should be strongly recommended in non-developed countries and it plays a main role in the rescuing. More case series are needed to share and improve the medical practice in dealing with this rare but fatal situation.