A rare case of a transabdominal impalement after a fall from a ladder

• The stick penetrated the patient at his left lumbar region, while its tip was palpable on his right abdomen.
• A computed tomography was performed due to the stable condition of the patient.
• When patient is unstable an emergency exploratory laparotomy should be performed.
• Drains were left until the 6th postoperative day due to increased levels of amylase.
• Antibiotic administration was discontinued on the 7th postoperative day because of the presence of gut perforation.

IntroductionImpalement injuries are caused by objects that penetrate and remain inside the human body. They are rare and often lead to complex surgical problems, demanding immediate measures and intensive care.Presentation of caseWe report a case of a 39 year old male who presented in our emergency department with a history of fall from a 3 m high ladder, landing on a wooden stick that penetrated the patient from his left lumbar region, leading to a trans-abdominal impalement injury.DiscussionNowadays impalement injuries although rare, demonstrate a challenging presentation for emergency providers. Their complexity often raises concerns about the proper surgical approach and postoperative management. In many cases, they may cause severe morbidity or even be lethal.ConclusionThe article describes a case of a transabdominal impalement injury and pinpoints the strategies followed regarding the prehospital care, as well as the intra- and postoperative management.