{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T12:16:54Z","timestamp":1756383414288,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,4,9]]},"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:p>Transperineal abdomino-thoracic impalement is a rare and complex penetrating injury that can present a significant challenge to surgeons worldwide. Due to its rarity, there are no established treatment guidelines for such scenarios. Management typically follows Advanced Trauma Life Support principles, emphasising the importance of a multidisciplinary approach. Detailed knowledge of the intricate anatomical relationships of the perineum and the catastrophic nature of such injuries is essential. To date, only eight cases of perineal impalement traversing the abdomen and thoracic cavity have been documented in the literature. Here, we describe the case of a male in his twenties who survived a transperineal abdomino-thoracic impalement with minimal morbidity, underscoring the importance of adhering to established principles in the management of impalement injuries.<\/jats:p>","DOI":"10.1136\/bcr-2025-265224","type":"journal-article","created":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T01:05:22Z","timestamp":1745975122000},"page":"e265224","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Transperineal abdomino-thoracic impalement"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9838-3954","authenticated-orcid":false,"given":"Nandakumar","family":"B M","sequence":"first","affiliation":[{"name":"General Surgery, MS Ramaiah Medical College, Bengaluru, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Srikantaiah","family":"Hiremath","sequence":"additional","affiliation":[{"name":"General Surgery, MS Ramaiah Medical College, Bengaluru, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mukund","family":"D","sequence":"additional","affiliation":[{"name":"General Surgery, MS Ramaiah Medical College, Bengaluru, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,4,29]]},"reference":[{"key":"2025082804412977000_18.4.e265224.1","doi-asserted-by":"crossref","first-page":"4365","DOI":"10.1007\/s00068-022-01908-z","article-title":"A systematic review of penetrating perineal trauma in a civilian setting","volume":"48","author":"Chong","year":"2022","journal-title":"Eur J Trauma Emerg Surg"},{"key":"2025082804412977000_18.4.e265224.2","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.ciresp.2015.11.010","article-title":"Treatment of complex perineal trauma. A review of the literature","volume":"94","author":"Petrone","year":"2016","journal-title":"Cir Esp"},{"key":"2025082804412977000_18.4.e265224.3","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1177\/000313480907500410","article-title":"Perineal injuries at a large urban trauma center: injury patterns and outcomes","volume":"75","author":"Petrone","year":"2009","journal-title":"Am Surg"},{"key":"2025082804412977000_18.4.e265224.4","doi-asserted-by":"crossref","first-page":"E232","DOI":"10.1177\/000313481107701109","article-title":"Nonfatal perineal impalement injury traversing pelvic, abdominal, and thoracic cavities","volume":"77","author":"Abdullahi","year":"2011","journal-title":"Am Surg"},{"key":"2025082804412977000_18.4.e265224.5","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijscr.2024.109652","article-title":"Perineal impalement extending through multiple cavities by iron rod following fall from elevated plane: Case report","volume":"120","author":"Sabino","year":"2024","journal-title":"Int J Surg Case Rep"},{"key":"2025082804412977000_18.4.e265224.6","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1007\/BF02617026","article-title":"Implacement injury of the rectum: an unusual case","volume":"10","author":"Kaufer","year":"1967","journal-title":"Dis Colon Rectum"},{"key":"2025082804412977000_18.4.e265224.7","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/0020-1383(81)90172-8","article-title":"Impalement injury by a tree branch from rectum to right nipple","volume":"12","author":"Lear","year":"1981","journal-title":"Injury"},{"key":"2025082804412977000_18.4.e265224.8","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1007\/s00068-002-1195-y","article-title":"Impalement Injury by a Wooden Branch","volume":"28","author":"Machens","year":"2002","journal-title":"Eur J Trauma"},{"key":"2025082804412977000_18.4.e265224.9","first-page":"473","article-title":"Transperineal thoracic impalement without diaphragmatic injury","volume":"65","author":"Ouzounian","year":"2008","journal-title":"J Trauma"},{"key":"2025082804412977000_18.4.e265224.10","doi-asserted-by":"crossref","DOI":"10.1155\/2009\/361829","article-title":"Survival Following Rectal Impalement through the Pelvic, Abdominal, and Thoracic Cavities: A Case Report","volume":"2009","author":"Moncure","year":"2009","journal-title":"Case Rep Med"},{"key":"2025082804412977000_18.4.e265224.11","first-page":"3","article-title":"Penetrating injury of pelvis, abdomen, and thorax in a child with a trident (Trishula)","volume":"4","author":"Rawat","year":"2013","journal-title":"APSP J Case Rep"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-265224","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:41:39Z","timestamp":1756381299000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-265224"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":11,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4,29]]},"published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1136\/bcr-2025-265224"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-265224","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,4]]}}}