iMedPub Journals

2012 JOURNAL OF UNIVERSAL SURGERY

Vol. 1 No. 2:2 doi: 10.3823/803

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Penetrating Intra-abdominal Injury Caused by High-pressure Water Jet

Bulent Calik
Buca Seyfi Demirsoy State Hospital, Surgery Department, Turkey. * Correspondence:

calikbulentdr@yahoo.com

Abstract
Increasing application is being found in industry for the highpressure water jet. In the literature, nearly all the reported cases of high-pressure jet injury have been from jets of oil, grease, or paint and usually to the hand. There were few penetrating intraabdominal injury cases due to high pressure jet. We presented a man age the 17 who had 1 cm penetrating wound and 5-mm incision at the level of the gallbladder in the liver and 5mm seromusculer incision in front of the gastric antrum. High pressure water jet injuries should be considered surgical emergencies. A high index of suspicion of associated internal injuries and aggressive surgical intervention are required

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Key words: abdominal trauma, liver, penetrating trauma, water jet

Introduction
Increasing application is being found in industry for the highpressure water jet. In the literature, nearly all the reported cases of high-pressure jet injury have been from jets of oil, grease, or paint and usually to the hand. There were few penetrating intraabdominal injury cases due to high pressure jet (1-3). A recent accident is described below.

Case Report
The patient, a man aged 17, was cleaning a car. As the lance was withdrawn the water jet was accidentally directed towards his abdomen. He was not wearing any protective clothing. After the accident he had right sided abdominal pain and bleeding at the abdominal skin. He was seen at our Emergency Department one hour after the accident . On the examination arterial blood pressure was low (90/60 mmHg), and tashycardia was present (120/dk). We detected 1 cm

penetrating wound and ten cm echymosis and superficial abrasion around of the wound in the right middle part of the abdomen. Widespread abdominal dephans and rebound was detected. The bowel sound were diminished. The haemoglobin level was 15. 6 mg/dL and the white cell count 13,300/ mm3. (85% neutrophils). Abdominal ultrasound examination showed fluid around the liver. The abdomen was explored under general anaesthesia through superior and inferior umblical median incision. There were detected 5-mm incision at the level of the gallbladder in the liver and 5mm seromusculer incision in front of the gastric antrum. Omentum had local hematoma. 100 cc serohemoragic liquid was observed in the peritoneal cavity. Primary repair was performed to the incisions. One drain were placed through the entry wound. Postoperatively the patient was given intramuscular cephalotin. He went home on the seven day after operation. He was last seen in the outpatient department two weeks later, when he was observed to be well and back at his previous work.

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iMedPub Journals

2012 JOURNAL OF UNIVERSAL SURGERY

Vol. 1 No. 2:2 doi: 10.3823/803

Our Site: http://www.imedpub.com/

Discussion
There were few penetrating intraabdominal injury cases due to high pressure jet in the literature.(4, 5) Neill and George described multiple perforations of the ileum and caecum caused by high-pressure water jet and Gardner reported a case in which a high-pressure water jet struck the abdominal wall at a tangentcausing a wound 10-cm long together with surgical emphysema. In this case recovery was uneventful (4, 5). Our patient had 5-mm incision at the level of the gallbladder in the liver and 5mm seromusculer incision in front of the gastric antrum. Omentum had local hematoma.100 cc serohemoragic liquid was observed in the peritoneal cavity. Primary repair was performed to the incisions urgently. One drain were placed through the entry wound. He recovered completely after seven day operation. High pressure water jet injuries should be considered surgical emergencies. A high index of suspicion of associated internal injuries and aggressive surgical intervention are required. Reducing these accident is more importantly. Strict safety precautions must be apply when using high-pressure water jet, including the wearing of a full suit of polyvinyl chloride clothing.

References
1. Tejero-Trujeque R. (2000) High-pressure water jet injuries: a surgical emergency. J Wound Care. 9(4): 175-9. 2. Curka PA, Chisholm CD. (1989) High-pressure water injection injury to the hand. Am J Emerg Med. 7(2): 165-7 3. Calder IM, Boustred D. (1980) High-pressure water jet injury. Br Med J. 280 (6231): 1620. 4. Neill RW, George B. (1969) Penetrating intra-abdominal injury caused by high-pressure water jet. Br Med J. 10; 2 (5653): 357-8. 5. De Beaux JL. (1980) High-pressure water jet injury. Br Med J. 14; 280 (6229): 1417-8.

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