Penetrating buttock trauma: A life-threatening injury that highlights the importance of good collaboration with trauma receiving hospitals.

A 54-year-old lady was brought to our emergency department after falling from a stepladder onto the base of her artificial Christmas tree. The metallic rod impaled her through the right buttock. X-rays and a computerized tomography were performed prior to transport to a trauma center causing delays to her surgery.

DISCUSSION

We are presenting the images of a patient who was brought to our emergency department after having sustained a penetrating buttock trauma, and we are discussing about the importance of early transfer to trauma centers.

Our patient is a 54‐year‐old lady who fell from a stepladder onto the metallic base of an artificial Christmas tree causing the stem of the tree to impale her through her right buttock into her pelvis.

Despite the impressive mechanism of injury, there was no immediate life‐threatening bleed, and the patient was subsequently transferred to the local Major Trauma Centre for expert surgical management but suffered significant delays due to the lack of clear transfer pathways.

Current literature recognizes that penetrating gluteal trauma should be considered a life‐threatening injury , and this case highlights learning points around the management of penetrating trauma in terms of investigations and early transfer for definitive treatment.

Imaging performed included X‐rays (Figure 1) and a CT scan (Figure 2) with 3D reconstruction (Figure 3). The above investigations required a significant amount of time including one and a half hour for fire brigade to cut off the metal pole for the patient to fit in the CT scanner.

FIGURE 1

Plain X‐ray

FIGURE 2

CT scan

FIGURE 3

3D reconstructed CT scan antero‐posterior view

Our aim is to stress the severity of penetrating buttock trauma and encourage clinicians to reflect on how trauma protocols work in their area.

AUTHOR CONTRIBUTIONS

Dimitrios Angelou: (1) Substantial contributions to the conception or design of the work, or the acquisition, analysis or interpretation of data. (2) Drafting the work or revising it critically for important intellectual content. (3) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Mark McKeever: (1) Drafting the work or revising it critically for important intellectual content. (2) Final approval of the version published. Amy Doran: (1) Drafting the work or revising it critically for important intellectual content. (2) Final approval of the version published. Momin Malik (Supervising author): (1) Substantial contributions to the conception or design of the work, or the acquisition, analysis or interpretation of data. (2) Final approval of the version published.

FUNDING INFORMATION

The authors of this paper did not receive any funding.

CONFLICT OF INTEREST

The authors of this paper do not have any conflicts of interest to declare.

ETHICAL APPROVAL

I Dimitrios Angelou consciously assure that for the manuscript “Penetrating buttock trauma: A life‐threatening injury that highlights the importance of good collaboration with trauma receiving hospitals” the following is fulfilled:

This material is the authors' own original work, which has not been previously published elsewhere.

The paper reflects the authors' own research and analysis in a truthful and complete manner.

The paper properly credits the meaningful contributions of co‐authors and co‐researchers.

The results are appropriately placed in the context of prior and existing research.

All sources used are properly disclosed (correct citation).

All authors have been personally and actively involved in substantial work leading to the paper.

CONSENT

Written informed consent was obtained from the patient to publish this report in accordance with the journal's patient consent policy.