Penetrating trauma to inner thigh causing bladder and sigmoid colon injury with retained intravesical foreign body – a case report

Penetrating injury to bladder is less common than blunt injury. This is a unique case of bladder injury due to penetrating trauma through inner thigh. We report a 16-Year-old boy came to Emergency with alleged history of accidental fall from a height of 10 feet over a vertically oriented, sharp pointed triangular asbestos sheet penetrating his right inner thigh into abdomen. A 30cm long asbestos sheath from the thigh was removed under local anesthesia. Patient presented with pallor, tachycardia, hypotension and abdominal guarding with hematuria on per urethral catheter. Patient was resuscitated and CT imaging done showed intravesical foreign body with bladder injury and pneumoperitoneum. Emergency laparotomy was done. Partial transection of sigmoid colon was identified. Bladder opened, foreign body retrieved and bladder injury repaired. This case of bladder injury is unique because of the entry-point and trajectory of the stab injury causing bladder and hollow viscus injury.