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Notes:
Volume 4 Journal of Pediatric Care
ISSN: 2471-805X
Page 23
JOINT EVENT
May 07-08, 2018 Frankfurt, Germany
&
3rd International Conference on Pediatrics and Pediatric Surgery
22nd Edition of International Conference on Neonatology and Perinatology
Shailesh Adhikary et al., J Pediatr Care, Volume 4
DOI: 10.21767/2471-805X-C2-008
Perforating injury of abdomen, thorax and neck in a child with a bamboo stick
Shailesh Adhikary, Saroj Rajbanshi, Anang Pangeni and Shashank Sood
BP Koirala Institute of Health Sciences, Nepal
Introduction: Penetrating or perforating abdominal or chest injuries are very uncommon in the paediatric age group and
are associated with a high mortality. Impalement injuries are consequence of penetration by elongated, usually fixed objects
through the body.
Case Summary: A 10-year young child suffered from a penetrating injury to the left iliac fossa when he had fallen down
from a coconut tree on to the sharp bamboo fence. The bamboo stick penetrated the abdominal wall, perforated the jejunal
loops at two sites along with the fundus of stomach, the left diaphragm, upper lobe of the left lung and the bevelled end of the
bamboo had exited at the neck after tearing apart the neck muscles and skin sweeping along with it few scattered pieces of
jejunal tissues which were seen lying alongside. He was brought to the hospital five hours after the accident. On arrival he was
in agony, dehydrated and scored 15/15 on Glasgow scale, remained haemodynamically stable, saturation of 93% with oxygen
supplement. On examination a 75x5 cm bamboo stick was in situ, which entered 4 cm medial to the left anterior superior iliac
spine and exited 3 cm above the skin at the posterior triangle of neck.
Operation: Imaging modalities were followed by exploration via the left thoracoabdominal incision. The thorax, mediastinum
and neck were assessed in the beginning and after confirming that no great vessels were at risk, the foreign body was then
carefully removed. The perforated stomach, jejunum and diaphragm were repaired. The upper lobe of lung had to be resected.
An abdominal drain and two intercostal drains were placed. The total operative time was 3.30 hours and the child was managed
in intensive care for four days and was finally discharged after two weeks.
Conclusion: A rare penetrating injury with damage to the multiple organs could be managed successfully possibly because of
teamwork and also due to some sensible move by the villagers as they did not try to fiddle around with the foreign body.
Biography
Shailesh Adhikary qualified as a Surgeon from Post Graduate Institute in Chandigarh, India in 1994 and currently working as a Clinical Teacher and a Surgeon
at the Community Based Medical College in Eastern Nepal for 12 years and has published 34 papers at national and international journals and is serving as an
Editorial Board Member for Asian Journal of Surgery. He is also the Governor of Endoscopic Laparoscopic Surgeons of Asia working to promote the Minimal Access
Surgery Development across Nepal and in Asia.