Injury patterns, diagnostic approaches and management of survivors of a naval torpedo attack: a maritime mass-casualty incident.

The sinking of the warship IRIS Dena by a torpedo attack on 4 March 2026 represents a rare maritime mass-casualty event. Because such events are relatively uncommon, the clinical outcomes of torpedo-related trauma remain poorly documented. This study describes the injury patterns among surviving crew members of a ship following a torpedo attack. A retrospective study was conducted including all 32 survivors admitted to the National Hospital Galle, Sri Lanka. Data regarding patient demographics, injury characteristics, initial investigations and management were extracted from medical records and analysed. All 32 survivors were male, with a mean age of 31.7 years. Eighteen patients (56.2%) reported only mild pain requiring standard analgesia. The remaining 14 patients (43.8%) sustained a total of 18 major traumatic injuries. Of these injuries, 10 (55.6%) were vertebral compression wedge fractures. Most vertebral fractures were concentrated at the thoracolumbar junction, with 6 (60%) involving T11 and L1 vertebrae. Five (27.8%) limb fractures were reported, including two scaphoid fractures, one femur fracture and two ankle fractures involving the lateral malleolus. One patient sustained severe chest trauma complicated with haemopneumothorax. The most used radiological imaging modality was spinal X-rays (n=15, 46.9%). Injuries among survivors of a torpedo attack predominantly consisted of thoracolumbar vertebral compression fractures. This specific injury pattern is likely attributable to the violent upward displacement of the ship, known as the "deck-slap" effect. Clinicians should use spinal immobilisation and subsequent spinal imaging in survivors of maritime explosions.