Surgical management of bull horn injury

Abstract

Background: Bull horn injuries are very frequent, especially in areas with a strong bullfighting tradition professional or amateur all over the world though it is uncommon in India.

Methods: A retrospective study of patients admitted to department of general surgery in IGGMC, Nagpur which is tertiary care hospital in central India with the diagnosis of wound by bull horn, between January 2002 and March 2016 was done. Sixty seven patients with bull horn injury were included prospectively.

Results: The vast majority of patients were male (80%), with only 13 women (20%). Male: Female ratio was 4:1. The mean age was 34 years for men and 28 years for women. The commonest site of injury was in the abdomen followed by the perineum, back and lower limb. The repair includes, 3 mesentric tear , 2 ileal perforation primary closure, 1 liver suture, 1 splenectomy, 1 gastric perforation primary closure, 1 bladder rupture primary closure, 1 primary closure of sigmoid perforation with proximal colostomy,1 primary repair of anorectal tear with functioning colostomy and 1 femoral vein repair. Perineal wound treated by primary repair and a de-functioning colostomy. The patient with partial avulsion of the scrotum was treated by a secondary closure. The average hospital stay was 7.9 days. Overall wound infection rate was 12.9%.

Conclusions: In rural India, bull is very useful animal for domestic and farming purpose. Early surgical treatment is required to prevent further morbidity and mortality.