Jiménez-Bobadilla B, Villanueva-Herrero JA, Santillán-Ruvalcaba J, Montaño TE, Charúa-Guindic L

Language: Spanish
References: 19
Page: 234-237
PDF size: 110.53 Kb.

ABSTRACT

Objective: Description of two cases of anal trauma due to bullhorn hurts. Site: Third Level Hospital, General Hospital of Mexico. O.D. Design: Case report. Description of the cases: Case 1. Male patient of 18 years old that had been aggressed by a fighting bull six hours before entering the hospital. It was observed a hurt of around 5 cm in the left posterior quadrant of the perianal area. The patient was taken to the operating room; the rigid rectosigmoidoscopy was normal and there was no lesion in sphincters. It was performed a debridation and hurt washing, with advances of skin flaps tatter rags, as well as administrating wide-spectrum antibiotics and anti-tetanus vaccination. Case 2. Male patient of 17 years old, having been aggressed 8 hours before his hospital admission. It was found a six-centimeter long anal and perianal hurt in the left anterior quadrant, with the section of both sphincters. The patient was taken to the operating room. During the rigid rectosigmoidoscopy, it was found anal duct disruption up to 2 cm above the anorectal line (or junction). Both debridation and sphincteroplasty were practiced at the second month of the follow-up period with normal continence. Conclusions: Bull-caused injuries are classified as contaminated wounds and require an exhaustive surgical washing and wide-spectrum intravenous antibiotics; besides this, it is recommended to apply anti-tetanus vaccination. If the sphincter is completely injured, and the surgeon has no experience to perform a sphincteroplasty, then a colostomy is a viable option.

REFERENCES

1. Crumplin MK. Matador versus taurus: bull gore injury. Comment on Lloyd MS (Ann R Coll Surg Engl 2004; 86: 3-5) Ann R Coll Surg Engl 2004; 86: 402.

2. Lloyd MS. Matador versus taurus: bull gore injury. Ann R Coll Surg Engl 2004; 86: 3-5.

3. Vázquez-Bayod R, Villanueva-Sáenz E, Gómez-García E. Aspectos generales en el manejo quirúrgico de las heridas por asta de toro en el Valle de México 1997-2000. Reporte de 42 casos. Rev Mex Ortop Traum 2000; 14: 302-8.

4. Zamora-Lomelí JA. Lesiones por embestida de toro de lidia en eventos civiles. Experiencia de 10 años. Cir Gen 2004; 26: 97-101.

5. Ríos-Pacheco M, Pacheco-Guzmán R, Padrón-Arredondo G. Heridas por asta de toro. Experiencia de un año en el Hospital General de O´Horán. Mérida, Yucatán. Cir Cir 2003; 71: 55-60.

6. Fragoso-Bernal JS, Ruiz-Roque R, Romero-Briones CG, Maldonado-Islas G. Lesiones por ganado de lidia en el estado de Tlaxcala, México: Un problema de salud originado por el folklore. Cir Gen 2004; 26: 102-6.

7. Chambres O, Thaveau F, Gabbai M, Giraud C, Gouffrant JM, Kretz JG. Une discipline atypique: la chirurgie taurine. A propos de deux observations. Ann Chir 2005; 130: 340-5.

8. Martínez-Ramos D, Miralles-Tena JM, Escrig-Sos J, Traver-Martínez G, Cisneros-Reig I, Salvador-Sanchís L. Heridas por asta de toro en el Hospital General de Castellón. Estudio de 387 pacientes. Cir Esp 2006; 80: 16-22.

9. Kudsk KA, Hanna MK. Management of complex perineal injuries. World J Surg 2003; 27: 895-900.

10. Belmonte-Montes C, Chávez-Rodríguez J, Hagerman-Ruiz-Galindo G, Hernández-Alejandro R. Trauma perianal severo, con lesión del esfínter anal. Reparación primaria del mecanismo del esfínter anal y colostomía en asa por laparoscopia. Una opción a considerar. Cir Gen 2001; 23: 256-9.

11. Siler V, Bebb K. Trauma to the perineum, anus, rectum and colon. Am J Surg 1950; 80: 652-62.

12. González RP, Phelan H 3rd, Hassan M, Ellis CN, Rodning CB. Is fecal diversion necessary for nondestructive penetrating extraperitioneal rectal injuries? J Trauma 2006; 61: 815-9.

13. Brill SA, Margolin DA. Anal sphincter trauma. Semin Colon Rectal Surg 2004; 15: 90-94.

14. Kusminsky RE, Shbeeb I, Makos G, Boland JP. Blunt pelviperineal injuries. An expanded role for the diverting colostomy. Dis Colon Rectum 1982; 25: 787-90.

15. Hellinger M. Anal trauma and foreign bodies. Surg Clin North Am 2002; 82: 1253-60.

16. Herr M, Wascher R, Gagliano R. Historial perspective and current management of traumatic injury to the extraperitoneal rectum and anus. Curr Surg 2005; 62: 625-32.

17. Rudloff U, Gonzalez V, Fernandez E, Holguin E, Rubio G, Lomelin J, et al. Chirurgica Taurina: A 10-year experience of bullfight injuries. J Trauma 2006; 61: 970-4.

18. Rebollo FJ, Bermejo M, López M, Utrillas A, del Val JM, et al. Heridas por asta de toro y el “paseíllo” del cirujano. Cir Esp 2001; 69: 525.

19. Jorge JM, Wexner SD. Etiology and management of fecal incontinence. Dis Colon Rectum 1993; 36: 77-97.