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Occult intraspinal glass injury
  1. S L Almond1,
  2. E C Jesudason1,
  3. P D Losty1,
  4. C L Malluci2
  1. 1Department of Paediatric Surgery, Alder Hey Children’s Hospital, Liverpool
  2. 2Department of Paediatric Neurosurgery, Alder Hey Children’s Hospital
  1. Correspondence to:
    Miss S Almond, University of Liverpool, Institute of Child Health, Alder Hey Children’s Hospital, Eaton Road, Liverpool L12 2AP, UK;
    salmond{at}liv.ac.uk

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Injuries due to glass are common in children.1 We present the case of a 4 year old female who fell into a glass cabinet at home. A relative promptly removed a piece of glass from the child’s left flank.

The child attended her district emergency department. She was cardiovascularly stable, with a clear chest, soft abdomen, and no neurological deficit. A 6 cm laceration to the left loin was noted. Abdominal and chest x ray examinations revealed a glass fragment lying at the T12 level of the vertebral column (fig 1). Computed tomography showed a 4 cm shard of glass entering the T12/L1 intervertebral foramen and displacing the spinal cord (fig 2). There was a left renal haematoma with normal urography.

The patient was transferred with spinal precautions to our unit, and wound exploration undertaken by general and neurosurgical teams. The intraspinal shard of glass was removed and a left renal capsular laceration identified. The child recovered uneventfully without neurological sequelae.

This case emphasises the need for meticulous assessment of penetrating glass injuries. Ideally, protruding fragments should not be removed prior to imaging. Residual shards should always be suspected. Fortunately, however, glass injuries to the spine remain extremely rare in children.2

   Figure 1
Figure 1

Plain radiograph showing the lower chest and upper abdomen. The retained glass fragment is clearly visible projected over the T12 vertebra.

   Figure 2
Figure 2

Computed tomographic scan showing a transverse section at T12. The glass fragment is seen entering the spinal canal at this level.

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