Sheathed goring: an unusual bull-horn injury

A 44-year-old man was referred after suffering bruises from bull horns. He complained of abdominal pain. Haemodynamically stable, he had contusion in the right hypochondrium with palpable evisceration and intact skin (Fig. 1). Urgent CT scan described periduodenal evisceration and rarefaction (Fig. 2). Emergency surgery was performed, evidencing evisceration of the small intestine in the right hypochondrium due to a 10 cm defect with mesenteric laceration (Fig. 3). The lesion was repaired by primary closure and retromuscular mesh. Postoperative period was without incidents and follow-up confirmed no recurrence of hernia.

Fig. 1

Fig. 2

Fig. 3

Sheathed goring accounts for <2% of abdominal wounds caused by bull horns and requires a high degree of suspicion

Conflict of interest

None of the authors have any conflict of interest.