A Case of Impalement Injury to the Rectum Treated Laparoscopically

Abstract

A 34-year-old man fell from mountain and was accidentally stabbed in his anus with a broken bamboo. He removed the bamboo and visited our hospital. He had diffuse abdominal tenderness with guarding and rigidity. Abdominal computed tomography scan showed free air around the rectum. Colonoscopy showed a defect of the half lumen of the rectal wall on the anterior side. An emergency surgery was performed under the clinical diagnosis of traumatic rectal perforation. Laparoscopic examination revealed minimal blood at the rectovesical pouch. A 4 × 1-cm perforation was found in the peritoneal reflection. Bamboo pieces located in the route of impalement injury were removed laparoscopically, and transanal suture was performed for the rectal perforation. The postoperative course was uneventful, and the patient was discharged on the 15th day. We report that laparoscopic evaluation was useful in the treatment of rectal impalement.