Abdominothoracic trauma due to impalement by an iron bar

Dr Biplab Mishra

Surgical exploration revealed the iron bar had ruptured almost 10cm of stomach, lacerated the left lobe of the liver, divided the central tendon of the left diaphragm and transected the upper half of the spleen. Posteriorly the diaphragm and left lung were lacerated before the bar exited the left posterior thoracic wall fracturing the tenth rib.
The bar was retrieved directly from the surgical incision. Splenectomy, gastrorrhaphy and left phrenorrhaphy were carried out and the lung laceration was repaired over three hours of operating. The patient remained stable throughout losing 400ml of blood. There were no post-operative complications.

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