Scrotal impaling injury causing ascending colon perforation and retroperitoneal fistula()

Impalement injuries though relatively uncommon are some of the most dramatic and are known to cause significant damage due to the forces involved, the combination of blunt and penetrating mechanisms, and wound contamination. They generally occur following falls from a height, motor vehicle accidents or other high velocity mechanisms. Their management requires specific consideration to the prehospital management of the impaling object, management of any organs injured and appropriate debridement and washout of the tract. We report a case of a scrotal impalement traversing the abdominal cavity and causing a colonic injury and a rib fracture which resulted in a chronic discharging sinus from the patient's retroperitoneum.