Management penetrating injury in Jombang Public Hospital district: a case report

Background: A penetrating injury is due to the mechanical force which is piercing in nature and caused by sharp-pointed objects. Penetrating trauma from the inguinal region to the thoracic region is a case with high morbidity and mortality when not sufficient early surgical assessment and good management. The penetrating injury needs early medical assessment and proper management, and this can be done in type B hospital. Case Description: Twenty-two years old male came to the emergency department in Jombang Public Hospital District after fell from 4 meters height in a construction project. We found 12 mm metallic foreign body has stabbed from right groin projected to left anterior axillary line ICS 4, and patient hemodynamically was stable without any signs of peritonitis. External genital examination showed bloody urethral discharge. We performed chest X-Ray, FAST sonography, prone and lateral KUB X-Ray, urethrographic and emergency exploratory laparotomy for foreign body extraction. Conclusion: Penetrating injury management involved supportive and surgical management toward damaged organs and extracted foreign body. The recommendation of penetrating injury is to keep the foreign body not to be manipulated since the foreign body can create a tamponade effect that can prevent massive bleeding.