{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T01:36:19Z","timestamp":1787967379016,"version":"build-2784847793"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T00:00:00Z","timestamp":1713484800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Perineal impalements, although rare, exhibit high morbidity and mortality, associated with penetrating traumas by long objects, often resulting from falls or assaults. The risk of pelvic bleeding and the need for immediate intervention to preserve vital organs are characteristics of these injuries, whose severity demands a multidisciplinary approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case description:<\/jats:title>\n                    <jats:p>A 57-year-old male patient, a victim of a 5-meter fall, suffered an extensive perineal impalement. With stable vital signs, he underwent the ATLS protocol, followed by whole-body computed tomography (WBCT), revealing a metallic object traversing the perineum, abdomen, and thorax. The surgery involved laparotomy, sternotomy, and removal of the object under direct visualization, with repair of prostatic, vesical, hepatic, and diaphragmatic injuries. The postoperative period included transfusions and urological follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>\n                      Perineal impalements require immediate attention, and their approach is influenced by clinical factors and the extent of the object. The importance of preoperative evaluation with tomography, removal of the object under direct visualization, and comprehensive surgical management is highlighted. The decision for conservative treatment is reserved for less severe cases\n                      <jats:bold>.<\/jats:bold>\n                      This work has been reported in line with the SCARE criteria.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Perineal impalements demand a rapid and integrated approach to optimize survival. Object removal, often performed by exploratory laparotomy, stands out as an essential procedure. Multidisciplinary expertise is crucial for the effective management of these complex injuries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This work has been reported in line with the SCARE criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2024.109652","type":"journal-article","created":{"date-parts":[[2024,4,20]],"date-time":"2024-04-20T23:04:53Z","timestamp":1713654293000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Perineal impalement extending through multiple cavities by iron rod following fall from elevated plane: Case report"],"prefix":"10.1097","volume":"120","author":[{"given":"Edilson Araujo","family":"Sabino","sequence":"first","affiliation":[{"name":"Complexo Hospitalar do Trabalhador, Avenida Rep\u00fablica Argentina, 4406 - Novo Mundo, Curitiba, PR 81050-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Arthur Borges","family":"da Silva","sequence":"additional","affiliation":[{"name":"Universidade Positivo, Rua Professor Pedro Viriato Parigot de Souza, 5300 - Cidade Industrial, Curitiba, PR 81280-330, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilherme Pasquini","family":"Cavassin","sequence":"additional","affiliation":[{"name":"Complexo Hospitalar do Trabalhador, Avenida Rep\u00fablica Argentina, 4406 - Novo Mundo, Curitiba, PR 81050-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcio Andre","family":"Sartor","sequence":"additional","affiliation":[{"name":"Complexo Hospitalar do Trabalhador, Avenida Rep\u00fablica Argentina, 4406 - Novo Mundo, Curitiba, PR 81050-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matheus Schmidt","family":"Evangelista","sequence":"additional","affiliation":[{"name":"Complexo Hospitalar do Trabalhador, Avenida Rep\u00fablica Argentina, 4406 - Novo Mundo, Curitiba, PR 81050-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebeca Trevisan","family":"Iurkiewiecz","sequence":"additional","affiliation":[{"name":"Complexo Hospitalar do Trabalhador, Avenida Rep\u00fablica Argentina, 4406 - Novo Mundo, Curitiba, PR 81050-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"4","key":"R1-3-20260325","first-page":"417","article-title":"Steel rod impalement injuries involving the spine: a case report and literature review","volume":"25","author":"Sarica,","year":"2019","journal-title":"Ulus. 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