{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:03:05Z","timestamp":1756425785512,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,6,10]]},"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:p>A 35-year old dockworker sustained a pelvic injury when he was caught by a large loading clamshell grab. Primary survey revealed an open book pelvic fracture with soft tissue defects of the left thigh and groin. CT scanning of the thorax and abdomen did not reveal significant additional injuries. Partly due to patient\u2019s haemodynamical instability, osteosynthesis of the pelvic fracture was performed immediately after resuscitation, whereby the severely contaminated wound of the thigh was debrided and irrigated. The following days, progressive facial subcutaneous emphysema developed, but patient remained clinically stable. Several specialists were consulted, but did not find a cause. At day 7, a second surgery was planned to treat a pelvic surgical wound infection. Unexpectedly, we found faecal contamination in the pelvic surgical wound. The consulted gastro\/intestinal-surgeon performed a laparoscopic colostomy for a rectal laceration. Awareness for bowel injuries with open pelvic fracture should be high, also when subcutaneous emphysema is found remotely.<\/jats:p>","DOI":"10.1136\/bcr-2020-241542","type":"journal-article","created":{"date-parts":[[2021,7,1]],"date-time":"2021-07-01T12:12:25Z","timestamp":1625141545000},"page":"e241542","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Facial subcutaneous emphysema due to rectum injury after pelvic fracture"],"prefix":"10.1136","volume":"14","author":[{"given":"Joost H","family":"Kuipers","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Erasmus Medical Center, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P Koen","family":"Bos","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Erasmus Medical Center, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Duncan E","family":"Meuffels","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Erasmus Medical Center, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,7,1]]},"reference":[{"key":"2025082801172109000_14.7.e241542.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2004.05.029"},{"key":"2025082801172109000_14.7.e241542.2","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/S0020-1383(99)90003-7","article-title":"The \u201cCrushed open pelvis\u201d in children","volume":"30","author":"Mosheiff","year":"1999","journal-title":"Injury"},{"key":"2025082801172109000_14.7.e241542.3","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1007\/s40719-014-0006-3","article-title":"Trauma to the pelvis: injuries to the rectum and genitourinary organs","volume":"1","author":"Wu","year":"2015","journal-title":"Curr Trauma Rep"},{"key":"2025082801172109000_14.7.e241542.4","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1097\/00005131-198802040-00012","article-title":"Occult rectal perforation in a major pelvic fracture","volume":"2","author":"Ebraheim","year":"1988","journal-title":"J Orthop Trauma"},{"key":"2025082801172109000_14.7.e241542.5","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1097\/00005131-198802030-00014","article-title":"Open pelvic fracture with vaginal laceration and diaphragmatic rupture in a child","volume":"2","author":"Heinrich","year":"1988","journal-title":"J Orthop Trauma"},{"key":"2025082801172109000_14.7.e241542.6","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/S0020-1383(99)00232-6","article-title":"Open pelvic fractures with vaginal laceration: an unusual clinical feature","volume":"31","author":"Kumar","year":"2000","journal-title":"Injury"},{"key":"2025082801172109000_14.7.e241542.7","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.1164\/rccm.201902-0276IM","article-title":"Pneumomediastinum due to traumatic rectal perforation","volume":"201","author":"Bots","year":"2020","journal-title":"Am J Respir Crit Care Med"},{"key":"2025082801172109000_14.7.e241542.8","unstructured":"Mobiel Medisch team. 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