<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2444-054X</journal-id>
<journal-title><![CDATA[Cirugía y cirujanos]]></journal-title>
<abbrev-journal-title><![CDATA[Cir. cir.]]></abbrev-journal-title>
<issn>2444-054X</issn>
<publisher>
<publisher-name><![CDATA[Academia Mexicana de Cirugía A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2444-054X2020000800031</article-id>
<article-id pub-id-type="doi">10.24875/ciru.20000168</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Perforación de colon secundaria a empalamiento autoinfligido: a propósito de un caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Colon perforation secondary to self-inflicted impalement: a case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lozada-Martínez]]></surname>
<given-names><![CDATA[Iván]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Periñan-Pérez]]></surname>
<given-names><![CDATA[Álvaro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Núñez-Rojas]]></surname>
<given-names><![CDATA[Gian]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bolaño-Romero]]></surname>
<given-names><![CDATA[María]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Muñoz-Murillo]]></surname>
<given-names><![CDATA[Willfrant]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Cartagena Centro de Investigaciones Médico Quirúrgicas ]]></institution>
<addr-line><![CDATA[Cartagena ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de Cartagena Hospital Universitario del Caribe Servicio de Cirugía General]]></institution>
<addr-line><![CDATA[Cartagena ]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2020</year>
</pub-date>
<volume>88</volume>
<fpage>31</fpage>
<lpage>34</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2444-054X2020000800031&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2444-054X2020000800031&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2444-054X2020000800031&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen El empalamiento es una causa grave y rara de lesión anorrectal, pudiendo darse en multitud de contextos, ya sea de índole accidental, psiquiátrica o por prácticas sexuales o criminales. El objetivo de este manuscrito es mostrar al autoempalamiento como agente causante de lesión anorrectal, de presentación extraordinaria. Se presenta un caso de empalamiento autoinfligido con perforación intestinal en un hombre de 44 años, que acudió al servicio de urgencias sin el objeto causante de la lesión y con un cuadro de abdomen agudo, debido a hemoperitoneo, peritonitis fecal y perforación en la unión rectosigmoidea.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract The impalement is a severe and rare cause of the anorectal lesion and can occur in a multitude of contexts, whether accidental, psychiatric or due to sexual or criminal practices. The objective of this manuscript is to show self-packing as the causative agent of anorectal lesion, being of extraordinary presentation. We present the case of self-inflicted impalement with intestinal perforation in a 44-year-old man, who attends the emergency department without the cause of the injury and with an acute abdomen, due to hemoperitoneum, fecal peritonitis and a perforation in the rectosigmoid junction.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Conducta autodestructiva]]></kwd>
<kwd lng="es"><![CDATA[Estreñimiento]]></kwd>
<kwd lng="es"><![CDATA[Perforación intestinal]]></kwd>
<kwd lng="es"><![CDATA[Peritonitis]]></kwd>
<kwd lng="en"><![CDATA[Self-injurious behavior]]></kwd>
<kwd lng="en"><![CDATA[Constipation]]></kwd>
<kwd lng="en"><![CDATA[Intestinal perforation]]></kwd>
<kwd lng="en"><![CDATA[Peritonitis]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Akakpo-Numado]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Boume]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Mihluedo-Agbolan]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Simlawo]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Adabra]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Tekou]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Perforation of large and small intestines by impalement in a 13-year-old boy]]></article-title>
<source><![CDATA[J Ped Surg Case Report]]></source>
<year>2014</year>
<volume>2</volume>
<page-range>206-8</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Oya]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Miyata]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Yuasa]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Takeuchi]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Goto]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Miyake]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Impalement injury to the left buttock with massive bleeding:a case report]]></article-title>
<source><![CDATA[Nagoya J Med Sci]]></source>
<year>2013</year>
<volume>75</volume>
<page-range>147-52</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Klein]]></surname>
<given-names><![CDATA[RR]]></given-names>
</name>
<name>
<surname><![CDATA[Scarborough]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Traumatic perforations of the rectum and distal colon]]></article-title>
<source><![CDATA[Am J Surg]]></source>
<year>1953</year>
<volume>86</volume>
<page-range>515-22</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bemelman]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Hammacher]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Rectal impalement by pirate ship:a case report]]></article-title>
<source><![CDATA[Injury Extra]]></source>
<year>2005</year>
<volume>36</volume>
<page-range>508-10</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mohan]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Ram]]></surname>
<given-names><![CDATA[DU]]></given-names>
</name>
<name>
<surname><![CDATA[Baba]]></surname>
<given-names><![CDATA[YS]]></given-names>
</name>
<name>
<surname><![CDATA[Shetty]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Bhandary]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Transabdominal impalement:absence of visceral or vascular injury a rare possibility]]></article-title>
<source><![CDATA[J Emerg Med]]></source>
<year>2011</year>
<volume>41</volume>
<page-range>495-8</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Linden]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Cendron]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Puder]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pediatric anorectal impalement with bladder rupture:case report and review of the literature]]></article-title>
<source><![CDATA[J Pediatr Surg]]></source>
<year>2006</year>
<volume>41</volume>
<page-range>E1-3</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hsieh]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Lu]]></surname>
<given-names><![CDATA[TC]]></given-names>
</name>
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[SY]]></given-names>
</name>
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[SC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pneumoretroperitoneum as the manifestation of rectal perforation]]></article-title>
<source><![CDATA[J Emerg Med]]></source>
<year>2011</year>
<volume>41</volume>
<page-range>536-7</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lupa&#351;cu]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Fotea]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Sârbu]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Andronic]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Rectal impalement injury:from cruelty to salvage endeavour]]></article-title>
<source><![CDATA[Chirurgia]]></source>
<year>2015</year>
<volume>110</volume>
<page-range>60-5</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rosat]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Sánchez]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Chocarro]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Barrera]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Impalement injury by glass shard with delayed colonic perforation]]></article-title>
<source><![CDATA[Pan Afr Med J]]></source>
<year>2015</year>
<volume>21</volume>
<page-range>330</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Black]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Pokorny]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[McGill]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Harberg]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Ano-rectal trauma in children]]></article-title>
<source><![CDATA[J Pediatr Surg]]></source>
<year>1982</year>
<volume>17</volume>
<page-range>501-4</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Carlos]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Newton]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Cecilia]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Heladio]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Héctor]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Perforación traumática del conducto anorrectal]]></article-title>
<source><![CDATA[Cir Cir]]></source>
<year>2005</year>
<volume>73</volume>
<page-range>453-6</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bonnard]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Zamakhshary]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Wales]]></surname>
<given-names><![CDATA[PW]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Outcomes and management of rectal injuries in children]]></article-title>
<source><![CDATA[Pediatr Surg Int]]></source>
<year>2007</year>
<volume>23</volume>
<page-range>1071-6</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Travassos]]></surname>
<given-names><![CDATA[DV]]></given-names>
</name>
<name>
<surname><![CDATA[Chrzan]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[van der Zee]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Late laparoscopic management of traumatic rectal injury without protective colostomy]]></article-title>
<source><![CDATA[J Laparoendosc Adv Surg Tech A]]></source>
<year>2009</year>
<volume>19</volume>
<page-range>843-4</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Marwan]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Harmon]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Georgeson]]></surname>
<given-names><![CDATA[KE]]></given-names>
</name>
<name>
<surname><![CDATA[Smith]]></surname>
<given-names><![CDATA[GF]]></given-names>
</name>
<name>
<surname><![CDATA[Muensterer]]></surname>
<given-names><![CDATA[OJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Use of laparoscopy in the management of pediatric abdominal trauma]]></article-title>
<source><![CDATA[J Trauma]]></source>
<year>2010</year>
<volume>69</volume>
<page-range>761-4</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Boettcher]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Kanellos-Becker]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Wenke]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Krebs]]></surname>
<given-names><![CDATA[TF]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Rectum perforation after broomstick impalement in a 17-year-old:case report and review]]></article-title>
<source><![CDATA[Pediatr Emerg Care]]></source>
<year>2013</year>
<volume>29</volume>
<page-range>510-2</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
