Surgical multidisciplinary approach to a complex war case with urological, colorectal and orthopaedics lesions

We present the case of a 21 years-old male who suffered major multiple injuries as the result of a mine explosion occurred on 19/09/23 in Armenia. They included shrapnel wounds involving the penile urethra, the bladder, the rectum, the anal canal and the upper and lower extremities and multiple frac...

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Main Authors: Francesco Quaglino, Antonella Evangelista, Marta Breda, Sara Ruscio, Gianluca Collo, Luca Cestino, Maria Antonucci, Stefania Soncini, Beatrice Degan, Salome Pfannkuche, Elisa Berdondini
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Trauma Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352644025000779
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author Francesco Quaglino
Antonella Evangelista
Marta Breda
Sara Ruscio
Gianluca Collo
Luca Cestino
Maria Antonucci
Stefania Soncini
Beatrice Degan
Salome Pfannkuche
Elisa Berdondini
author_facet Francesco Quaglino
Antonella Evangelista
Marta Breda
Sara Ruscio
Gianluca Collo
Luca Cestino
Maria Antonucci
Stefania Soncini
Beatrice Degan
Salome Pfannkuche
Elisa Berdondini
author_sort Francesco Quaglino
collection DOAJ
description We present the case of a 21 years-old male who suffered major multiple injuries as the result of a mine explosion occurred on 19/09/23 in Armenia. They included shrapnel wounds involving the penile urethra, the bladder, the rectum, the anal canal and the upper and lower extremities and multiple fractures of the pelvis. Initially he underwent a stabilizing surgery at the field hospital; he was then transferred to the Astghik Medical Center where a new emergency surgery was performed with the creation of a lateral colostomy and the placement of a midline cystostomy drainage.On 08/10/23, the patient was admitted to the Department of Surgery at Maria Vittoria Hospital in Turin, Italy, with signs of sepsis. Broad-spectrum intravenous antibiotic therapy was promptly initiated. A week later, due to the persistence of the septic state, we performed a surgical abdominal revision consisting of a drainage of multiple intraperitoneal abscesses and resection of the injured rectal tract with conversion of the lateral colostomy into a terminal one, a direct repair of a leakage found in the bladder and a replacement of the cystostomy dreinage. The patient was discharged in good conditions 45 days after surgery.Five months later, the patient underwent a Hartmann's reversal with a Knight-Griffen anastomosis combined with urethral and perineal reconstruction, pubectomy, cystorrhaphy and placement of a new lateral cystostomy. The patient was discharged 45 days after surgery in good clinical conditions. The cystocath and the bladder catheter were removed in outpatient setting two weeks later.
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spelling doaj-art-abf3fddc1bf0454dbf6b101639876de72025-08-20T03:36:19ZengElsevierTrauma Case Reports2352-64402025-08-015810120010.1016/j.tcr.2025.101200Surgical multidisciplinary approach to a complex war case with urological, colorectal and orthopaedics lesionsFrancesco Quaglino0Antonella Evangelista1Marta Breda2Sara Ruscio3Gianluca Collo4Luca Cestino5Maria Antonucci6Stefania Soncini7Beatrice Degan8Salome Pfannkuche9Elisa Berdondini10Chirurgia Generale 1- Ospedale Maria Vittoria, Torino, ItalyChirurgia Generale 1- Ospedale Maria Vittoria, Torino, ItalyChirurgia Generale 1- Ospedale Maria Vittoria, Torino, Italy; Corresponding author at: Chirurgia Generale 1, Ospedale Maria Vittoria, via Cibrario 72, 10144 Torino, Italy.Chirurgia Generale 1- Ospedale Maria Vittoria, Torino, ItalyOrtopedia – Ospedale Maria Vittoria, Torino, ItalyChirurgia Generale 1- Ospedale Maria Vittoria, Torino, ItalyChirurgia Generale 1- Ospedale Maria Vittoria, Torino, ItalyChirurgia Generale 1- Ospedale Maria Vittoria, Torino, ItalyChirurgia Generale 1- Ospedale Maria Vittoria, Torino, ItalyChirurgia Generale 1- Ospedale Maria Vittoria, Torino, ItalyUrologia - Ospedale San Giovanni Bosco, Torino, ItalyWe present the case of a 21 years-old male who suffered major multiple injuries as the result of a mine explosion occurred on 19/09/23 in Armenia. They included shrapnel wounds involving the penile urethra, the bladder, the rectum, the anal canal and the upper and lower extremities and multiple fractures of the pelvis. Initially he underwent a stabilizing surgery at the field hospital; he was then transferred to the Astghik Medical Center where a new emergency surgery was performed with the creation of a lateral colostomy and the placement of a midline cystostomy drainage.On 08/10/23, the patient was admitted to the Department of Surgery at Maria Vittoria Hospital in Turin, Italy, with signs of sepsis. Broad-spectrum intravenous antibiotic therapy was promptly initiated. A week later, due to the persistence of the septic state, we performed a surgical abdominal revision consisting of a drainage of multiple intraperitoneal abscesses and resection of the injured rectal tract with conversion of the lateral colostomy into a terminal one, a direct repair of a leakage found in the bladder and a replacement of the cystostomy dreinage. The patient was discharged in good conditions 45 days after surgery.Five months later, the patient underwent a Hartmann's reversal with a Knight-Griffen anastomosis combined with urethral and perineal reconstruction, pubectomy, cystorrhaphy and placement of a new lateral cystostomy. The patient was discharged 45 days after surgery in good clinical conditions. The cystocath and the bladder catheter were removed in outpatient setting two weeks later.http://www.sciencedirect.com/science/article/pii/S2352644025000779War woundsExplosion injuriesMultiorgan injuryMultidisciplinary approachUrethral reconstructionRectal injuries
spellingShingle Francesco Quaglino
Antonella Evangelista
Marta Breda
Sara Ruscio
Gianluca Collo
Luca Cestino
Maria Antonucci
Stefania Soncini
Beatrice Degan
Salome Pfannkuche
Elisa Berdondini
Surgical multidisciplinary approach to a complex war case with urological, colorectal and orthopaedics lesions
Trauma Case Reports
War wounds
Explosion injuries
Multiorgan injury
Multidisciplinary approach
Urethral reconstruction
Rectal injuries
title Surgical multidisciplinary approach to a complex war case with urological, colorectal and orthopaedics lesions
title_full Surgical multidisciplinary approach to a complex war case with urological, colorectal and orthopaedics lesions
title_fullStr Surgical multidisciplinary approach to a complex war case with urological, colorectal and orthopaedics lesions
title_full_unstemmed Surgical multidisciplinary approach to a complex war case with urological, colorectal and orthopaedics lesions
title_short Surgical multidisciplinary approach to a complex war case with urological, colorectal and orthopaedics lesions
title_sort surgical multidisciplinary approach to a complex war case with urological colorectal and orthopaedics lesions
topic War wounds
Explosion injuries
Multiorgan injury
Multidisciplinary approach
Urethral reconstruction
Rectal injuries
url http://www.sciencedirect.com/science/article/pii/S2352644025000779
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