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01.12.2014 | Case report | Ausgabe 1/2014 Open Access

BMC Emergency Medicine 1/2014

Thoraco- abdominal impalement injury: a case report

BMC Emergency Medicine > Ausgabe 1/2014
Gyanendra Malla, Bibhusan Basnet, Rais Vohra, Casey Herrforth, Shailesh Adhikari, Amit Bhandari
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1471-227X-14-7) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

GM, SA conducted and coordinated the case. GM, BB, RV, CH and AB conceived the case report, and participated in its design. BB, AB and RV and CH drafted the manuscript and sequence alignment of the report. BB, RV and CH reviewed the literature. All authors read and approved the final manuscript.



Impalement injury is an uncommon presentation in the emergency department (ED), and penetrating thoraco-abdominal injuries demand immediate life-saving measures and prompt care. Massive penetrating trauma by impalement in a pediatric case represents a particularly challenging presentation for emergency providers in non-trauma center settings.

Case presentation

We report a case of 10 year old male who presented in our ED with an alleged history of fall from an approximately 15 foot tall coconut tree, landing over an upright bamboo stake approximately 50 centimeter long, resulting in a trans-abdomino, trans-thoracic injury. In addition to prompt resuscitation and hospital transfer, assessment of damage to vital structures in conjunction with surgical specialty consultation was an immediate goal.


This article describes a case study of an impalement injury, relevant review of the available literature, and highlights the peculiar strategies required in the setting of a resource limited ED.
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