Discovery of a glass splinter in the abdominal cavity after an old impalement injury: A case report and literature review

Abstract

Patient: Female, 52-year-old Final Diagnosis: Foreign body in the abdominal cavity Symptoms: Abdominal pain • hip pain Medication: — Clinical Procedure: Laparotomy Specialty: Surgery Objective: Unusual clinical course Background: Intra-abdominal impalement injuries caused by a penetrating foreign body are rare and often fatal. The mech-anism of injury is usually associated with vascular and organ damage, and the course is dynamic, with high morbidity and mortality. Post-traumatic presence of glass pieces in the peritoneal cavity after an old impalement injury is rare. Case Report: A 52-year-old woman sustained a 4-cm laceration in her lumbar region after falling on a glass table that shat-tered. After a physical examination and wound exploration in the emergency room, no foreign body was found. The laceration was sutured without X-ray imaging. She was admitted to the Surgical Department 9 months later for diagnosis of lower abdominal pain. In a CT scan of the abdominal cavity, a 19-cm fragment of glass was found intraperitoneally, inter-looped in the pelvic cavity. A laparotomy was performed, during which the foreign body was found and removed. No abdominal organs were injured. Further outpatient treatment was normal. Conclusions: Potentially minor abdominal impalement injuries can cause serious organ damage. Every patient, even if as-ymptomatic, and even after trivial injury with a small skin wound, must be suspected of having a hidden foreign body. Accurate visual, manual, and instrumental wound exploration is always necessary. Imaging exams are an important diagnostic method when the presence of a post-traumatic foreign body is suspected.