Uncommon rectal impalement injury with an unexpected intraabdominal trauma

Abstract

Rectal penetrating injuries are a very rare and potentially lethal form of trauma in children. We report the case of a rectal impalement injury (RII) in a 3-year-old female patient after an almost unbelievable accident at home. Laparotomy revealed a traumatic rectal wall perforation. Initially, we had a high suspicion of child abuse.Later, the child was readmitted with vomiting and elevated inflammation parameters. Diagnostics including MRI showed an intrahepatic foreign body abscess, which was treated laparoscopically. We found a piece of diaper residue consistent with the trauma mechanism reported by the parents.With this case report we would like to draw attention to a very unusual and almost incredible injury, its sequelae and challenges.

Keywords

• Rectal impalement injury
• Liver abscess
• Liver injury
• Children
• Child abuse