Integrated trauma care successfully treats a severe case of combined steel bar penetration injury to the head, neck, chest, and abdomen: A case report and literature review.

RATIONALE

Penetrating injuries spanning multiple anatomical regions carry significant risks of morbidity and mortality. Successful management depends on coordinated prehospital care, expedited imaging, and a multidisciplinary surgical approach. This case report details the successful management of an exceptionally severe combined penetrating injury involving the head, neck, chest, and abdomen, emphasizing the critical role of an integrated trauma care system. It serves to highlight the importance of standardized trauma protocols for optimizing outcomes in such complex and life-threatening injuries.

PATIENTS CONCERN AND DIAGNOSIS

The patient exhibited acute distress, hemodynamic instability, and 2 penetrating steel rebars traversing the head, neck, chest, and abdomen. Computed tomography (CT) scans revealed trajectories through critical structures, including the right orbit, cervical vascular sheath, and intra-abdominal organs, prompting immediate surgical intervention.

INTERVENTIONS

Emergency response: the trauma resuscitation team was activated, followed by fluid resuscitation and urgent CT imaging. Surgical procedures: (1) Open wound debridement and foreign body removal; (2) diaphragmatic repair and liver laceration management; (3) closed thoracic drainage and clavicle fracture fixation; (4) postoperative care: intensive monitoring, infection prevention, and rehabilitation.

OUTCOMES

(1) Successful stabilization and foreign body extraction; (2) full recovery with near-complete functional restoration by postoperative day 20; (3) no significant complications observed during follow-up.

LESSONS

(1) Multidisciplinary collaboration and standardized trauma protocols are vital for complex cases; (2) CT imaging remains indispensable despite metallic artifacts; (3) institutional preparedness and continuous team training improve trauma care efficacy.