Abstract
We report herein on the successful treatment of an anorectal impalement injury that reached the chest cavity. A 52-year-old male construction site worker fell from a height onto a reinforcing bar that entered his body through the anus. The rebar was removed at the site without emergency transportation or a rescue request. When he reached our hospital he was fully conscious and only complained of pain. A thoracoabdominal computed tomography scan revealed left hemopneumothorax and a small amount of ascites. He underwent emergency surgery under general anesthesia. During the laparotomy, part of the rectum was observed to be damaged ; we repaired this damage and reconstructed an artificial sigmoid anus with double orifices. Furthermore, mesenteric, gastric, and diaphragmatic damage were detected via an intraperitoneal examination. During thoracotomy, following the abdominal injury repair, hemorrhagic pleural effusion including saburra and damage to the lingula of the left lung were observed ; therefore, we inferred that the rebar had also pierced the lung via the abdominal cavity. The heart and major blood vessels were not damaged. After surgery, 5-day intensive treatment was required ; however, the patient showed satisfactory progress and was discharged from the hospital on day 21 post-surgery.
