title: Two cases of penetrating abdominal injury from needlefish impalement.
abstract: BACKGROUND
  Needlefish injuries to humans are extremely rare. An extensive review of the medical literature reveals only 22 cases previously reported. Most injuries reported have occurred in the Indo-Pacific region, but there are scattered reports worldwide.
  
  
  OBJECTIVE
  To report two cases of life-threatening penetrating abdominal injuries from needlefish impalement.
  
  
  METHODS
  A 19-year-old man and a 40-year-old woman were both struck in the abdomen by a needlefish and required emergent exploratory laparotomy for instability. Their injuries were a laceration of a branch of the left portal vein and a small bowel perforation, respectively. Both patients survived and recovered without incident.
  
  
  CONCLUSIONS
  Although rare, penetrating injuries from needlefish can be life threatening. Treatment should be directed at the organ injured with appropriate antibiotic coverage.
authors.affiliation: University of Hawaii Surgical Residency Program, Honolulu, HI 96813, USA.
authors.forename: Justin James
authors.initials: JJ
authors.lastname: Clark
authors.forename: Hao Chih
authors.initials: HC
authors.lastname: Ho
mesh_terms: D000328:Adult; D000818:Animals; D023761:Beloniformes; D005260:Female; D006254:Hawaii; D006465:Hemoperitoneum / Q000209:etiology / Q000601:surgery; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology* / Q000601:surgery; D007421:Intestine, Small / Q000293:injuries* / Q000601:surgery; D008297:Male; D011169:Portal Vein / Q000293:injuries* / Q000601:surgery; D014951:Wounds, Stab / Q000209:etiology* / Q000601:surgery; D055815:Young Adult