Injury of Homemade Speargun Accidents in River Valley Villagers: A Case Series

Summary: Penetrating injuries from homemade spearguns are common, serious injuries, especially in river basin areas or after flooding. Harpoon injuries are unique and affect surgical treatment planning. This study focuses on managing speargun injury to the torso from pre-hospital to definitive repair. This case-series study presented five patients injured by a homemade speargun to the torso and attended to the trauma level one center, describing management in the context of the Khon Kaen University experience. All patients were injured by the fixed-type barbed metal harpoon. Three patients were shot in the chest, and two were shot in the abdomen. All patients were hemodynamically stable. Since each harpoon has a fixed-type barb, it cannot be pulled out retrogradely, so they must be immobilized from a pre-hospital setting, and all patients must undergo surgery. The standard surgical exposure is used to remove the harpoon in an antegrade direction to prevent further tissue injury. Speargun injuries are challenging and can occur after flooding when there are few facilities available. The harpoon needs to be immobilized from prehospital and surgically removed. To facilitate the operation or investigation, it is sometimes necessary to cut the protruding part of the harpoon using a large bolt clipper with at least two adjustable wrenches to hold the harpoon in place. The recommendation is that the patient should be positioned in the supine position for effective standard surgical management. Since this type of injury can occur after a flooding disaster, it is important to prepare for it.