Oode Yasumasa, Maruyama Tetsuro, Kimura Masayuki, Fukunaga Toru, Omori Kazuhiko, Yanagawa Youichi
Department of Acute Critical Care Medicine Juntendo University Shizuoka Hospital Izunokuni Shizuoka Japan.
Department of Surgery Numazu City Hospital Numazu Shizuoka Japan.
Acute Med Surg. 2015 Jun 30;3(1):3-9. doi: 10.1002/ams2.118. eCollection 2016 Jan.
A 16-year-old male was transported to our emergency department after he was kicked in the abdomen by a horse. He was diagnosed with injury of the liver and abdominal rectus muscle, and was cured by observational treatment. An Ichushi search was undertaken to identify articles published from 1983 to 2013 using the key words "horse" and "trauma". We found 13 cases that described horse-related injuries and summarized these cases, including our case. There were 10 males, three females and one patient of an undescribed sex. The patients ranged in age from 16 to 58 years old, with an average age of 33 years. The injured sites were predominantly the face (mandible) and upper abdomen, indicating that a projecting part of the body may be more likely to be injured. Cardiac rupture, aortic head injury, or lethality induced by a horse kick have not been reported in Japan, but such injuries have been reported in other countries. Ten of 15 cases (67%) required surgical treatment for severe injuries. Horse kick injuries tend to be severe, because the transfer of energy from the end of the hoof, with a small cross-sectional area, to a small field, leads to internal organic injuries that are more severe than predicted, similar to a handlebar injury. Accordingly, we advocate the close observation of patients with horse kick injuries, which may be regarded as being similar to blunt stab wounds or hidden speared injuries.
一名16岁男性在被马踢中腹部后被送往我们的急诊科。他被诊断为肝脏和腹直肌损伤，经观察治疗后痊愈。我们进行了一次文献检索，以确定1983年至2013年期间发表的使用关键词“马”和“创伤”的文章。我们发现了13例描述与马相关损伤的病例，并对这些病例进行了总结，包括我们的病例。其中男性10例，女性3例，1例性别未描述。患者年龄在16岁至58岁之间，平均年龄为33岁。受伤部位主要是面部（下颌骨）和上腹部，这表明身体的突出部位可能更容易受伤。在日本尚未报告过因马踢导致的心脏破裂、主动脉头部损伤或致死情况，但其他国家有此类损伤的报告。15例中有10例（67%）因重伤需要手术治疗。马踢伤往往较为严重，因为能量从横截面较小的马蹄末端传递到较小的区域，会导致比预期更严重的内部器官损伤，类似于车把伤。因此，我们主张对马踢伤患者进行密切观察，这类损伤可被视为类似于钝器刺伤或隐匿性刺伤。
