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/
