Korean J Urol.  2012 Jun;53(6):435-437.

Impalement Injury of the Urinary Bladder: A Case Report

• Morita J
• Naoe M
• Nakasato T
• Ogawa Y

Abstract

Impalement injury of the urinary bladder, especially secondary to rectal impalement, is extremely rare. In this case, a 31-year-old man sustained a steel pipe impalement injury through his perirectal region. He presented with gross hematuria, abdominal defense, and a penetrating wound. On the basis of the computed tomography findings and abdominal defense, we suspected a through-and-through bladder perforation from the rectal space to the intraperitoneum. Laparotomy revealed a through-and-through bladder perforation as well as damage to the right ureter, 3 distinct ileal injuries, and rectal anterior, anal, and right seminal vesicle injuries. Surgical repair of each damaged site was undertaken. The prompt diagnosis and surgical repair ensured good postoperative recovery.

Keyword

Bladder injuries; Rupture; Urinary bladder

MeSH Terms

Adult
Hematuria
Humans
Laparotomy
Rupture
Seminal Vesicles
Steel
Ureter
Urinary Bladder
Wounds, Penetrating
Steel

Figure

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  FIG. 1 A 2-cm diameter penetrating wound (impalement injury) with bleeding in the perirectal region around the anus.

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  FIG. 2 Computed tomography scans showed a high-density area and free air in the bladder (A) and that the posterior dome of the bladder wall was irregular (B).

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  FIG. 3 Injury tracks confirmed by operative findings.

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