A Case of Traumatic Abdominal Wall Hernia and Mesenteric Injury Caused by the Thrust of a Cow's Horn

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  • 牛の角による外傷性腹壁ヘルニア, 腸間膜損傷の1例

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Abstract

We experienced a case of traumatic abdominal wall hernia and mesenteric injury caused by a cow's horn. The patient was a 46-year-old man, whose cow had thrust him against a wall with her horn stuck against the lower right quadrant of his abdomen. He visited the emergency department of our hospital because of abdominal pain, despite exhibiting minor external injuries. An examination showed abrasion and subcutaneous bleeding in the lower right quadrant of the abdomen, but the skin was intact. An abdominal echography revealed an echo-free space under the surface of the liver and between the kidney and the adjacent liver and spleen, as well as in the right paracolic gutter. We diagnosed the patient as having intraabdominal bleeding, and emergency surgery revealed a traumatic abdominal hernia where the horn had struck and an ileal mesenteric injury. The bleeding was stopped, and the wound was sutured. The postoperative course was uncomplicated, and the patient was discharged on Day 12. An object that is both sharp and blunt, like a cow's horn, may rupture deep-lying tissues and cause organ damage, even if the skin is intact. Therefore, it is important to consider the mechanism of injury before making a diagnosis and treating the injury.

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