Okano Ichiro, Midorikawa Yuki, Kushima Nobumasa, Watanabe Yui, Sugiyama Takuya, Mitachi Katsutaka, Shinohara Kazuaki, Sawada Takatoshi, Inagaki Katsunori
Department of Orthopaedic Surgery (Drs Okano, Midorikawa, Kushima, and Sawada), Ohta-Nishinouchi Hospital, Koriyama, Japan.
Department of Orthopaedic Surgery (Drs Okano, Midorikawa, Kushima, and Sawada), Ohta-Nishinouchi Hospital, Koriyama, Japan.
Wilderness Environ Med. 2018 Sep;29(3):375-379. doi: 10.1016/j.wem.2018.02.007. Epub 2018 May 3.
Wild boar attacks have rarely been reported in the medical literature. This is the case of an 83-year-old male farmer who was assaulted from behind by an injured adult wild boar. He presented with hemorrhagic shock after sustaining injuries to the right profunda femoris artery and right sciatic nerve as well as significant soft-tissue injuries, bilateral iliac wing fractures, an open pneumothorax, and an anorectal injury. The anorectal injury was treated with fecal diversion but was complicated by soft-tissue infection in the surrounding dead space. The patient needed multiple operations, including removal of the distal rectum and creation of a permanent colostomy. In this report, we highlighted the characteristics of anorectal trauma caused by a wild boar attack. We conclude that penetrating anorectal injuries caused by this type of attack can be associated with extensive soft-tissue damage despite externally appearing to be simple puncture wounds. Anorectal combat injuries have demonstrated similar extensive surrounding soft-tissue injuries and propensity for infection; therefore, this case supports adopting a similar treatment strategy, that of serial and radical debridement, to treat certain wild boar injuries.
野猪袭击事件在医学文献中鲜有报道。本文讲述的是一名83岁男性农民的案例,他遭到一头受伤成年野猪从背后袭击。他因右股深动脉和右坐骨神经受伤以及严重的软组织损伤、双侧髂骨翼骨折、开放性气胸和肛肠损伤而出现失血性休克。肛肠损伤采用粪便转流治疗,但因周围死腔的软组织感染而出现并发症。患者需要多次手术,包括切除直肠远端并进行永久性结肠造口术。在本报告中,我们强调了野猪袭击导致的肛肠创伤的特点。我们得出结论,尽管此类袭击造成的穿透性肛肠损伤外表看似只是简单的刺伤,但可能伴有广泛的软组织损伤。肛肠战伤也表现出类似的广泛周围软组织损伤和感染倾向;因此,本病例支持采用类似的治疗策略,即分期彻底清创,来治疗某些野猪致伤情况。