Cited 14 times since 2007 (0.8 per year) source: EuropePMC Journal of pediatric surgery, Volume 42, Issue 9, 1 1 2007, Pages E23-5 Anorectal impalement in a pediatric patient with transanal evisceration of small bowel. Bronkhorst MW, Wilde JC, Hamming JF, Heij HA

Rectal injuries in the pediatric population are most often attributed to accidental falls on offending objects, sexual abuse, or blunt trauma. Anorectal impalement is a rare injury, and as a result, specific knowledge or experience on the treatment of this type of injury in children is sparse. The extent of injury is often difficult to assess. Mostly, therapeutical decisions are based on general knowledge in adults. We present a case of accidental anorectal impalement in a child by a fall on the handle of a toilet brush. The handle caused an anterior rupture of the intraperitoneal part of the rectum with subsequent transanal evisceration of several loops of small bowel.

J Pediatr Surg. 2007 9;42(9):E23-5