Penetrating Sacral Injury by Wooden Foreign Object

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Penetrating Sacral Injury
A pelvic X-ray shows sacral bone defect (a). The axial (b) and sagittal (c) CT scan of lumbosacral area shows a hypodense penetrating object that was introduced from the posterior aspect of the sacrum and then stopped in the S1 vertebral body. Also, intraoperative illustration can be observed before (d) and after (e) wood removal.

Case of spinal penetrating trauma, sacral injury.

This article highlights the case of a 55-year-old Afghani male patient who presented to the emergency with a laceration on the sacral area, 12 cm above the anus. The laceration measure 1 x 1 cm. The penetrating sacral injury occurred when the patient fell from a mulberry tree. On presentation to the emergency, there were no neurologic deficit or fever with normal sphincter function.

The laceration was dirty with slow CSF leaking. Doctors advised a pelvic X-ray which showed an area of defect in the sacral region. The patient’s CT showed a hypodense penetrating object entering from the posterior aspect of the sacrum into the dural space. The foreign object stopped in the S1 vertebral body and did not penetrate the anterior cortex of the vertebral body. The patient was referred to general surgery because of the possibility of a pelvic organ injury. Based on the surgical consultation and normal examination findings, the surgeon assured the doctors.

The foreign body was removed under general anaesthesia while the patient was in a prone position. Dissection of the muscle showed a wooden foreign body on the sacral lamina, passing into the S1 body. The wooden foreign body was pulled out from the surrounding bone after laminectomy of an intact superior portion of the S1 lamina. The patient was closely observed for 3 days. On discharge the patient had no deficit or complication. The patient’s wound had healed at 2-weeks follow up. The patient was doing fine even 8 months after the procedure, as reported over the phone. He did not show up for a follow-up because of the different nationality.

References

Penetrating Sacral Injury with a Wooden Foreign Body https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5933016/

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Dr. Aiman Shahab is a dentist with a bachelor’s degree from Dow University of Health Sciences. She is an experienced freelance writer with a demonstrated history of working in the health industry. Skilled in general dentistry, she is currently working as an associate dentist at a private dental clinic in Karachi, freelance content writer and as a part time science instructor with Little Medical School. She has also been an ambassador for PDC in the past from the year 2016 – 2018, and her responsibilities included acting as a representative and volunteer for PDC with an intention to make the dental community of Pakistan more connected and to work for benefiting the underprivileged. When she’s not working, you’ll either find her reading or aimlessly walking around for the sake of exploring. Her future plans include getting a master’s degree in maxillofacial and oral surgery, settled in a metropolitan city of North America.

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