DISCLAIMER/WARNING – This post is a bit graphic, so please be advised.
The mascot at our current institution, University of South Florida (Tampa, FL) is the bull. Therefore, we have been fond of the many bulls we have seen here in Peru, and have been trying to take lots of pictures of them, some even while posing with them. We even have our own Peruvian bull that we take around with us….his name is Teodoro El Toro.
Typical scene in Peru of locals herding their bulls or other livestock.
Us trying to get a pose with our beloved mascot, the bulls.
However, recently we had a patient come in to the clinic with a horrible gash in her lower abdomen. Upon further questioning, we found that she had actually been stuck by a bull!
Wound shown in the suprapubic region, resulting from being stuck by a bull.
On initial work-up and exam of the woman, she appeared to be in pain, but not in significant distress. She was alert and oriented with stable vital signs. We started an IV to get some fluids in her, and then started to strategize how we could close the wound.
In the Centro de Salud Pisac, there is no operating room, only a simple triaje room used for minor procedures. We put the woman on an exam table in this room, and tried to drape her with as many sterile gowns as we could find, and cleaned the wound with saline and some iodine. We used local anesthetic (basically, using a hypodermic needle we injected lidocaine all around the wound, but the patient was alert and awake throughout the procedure) to numb the area where we were trying to operate. After the Peruvian doctor who I was working with sewed up the peritoneum, I took over, and sewed up the remaining fascial layers and skin. We didn’t have a real drain, so we had to cut a strip from a sterilized glove and used that as a drain. The patient was then hospitalized at the clinic, and started on antibiotics (I believe ampicillin and gentamycin was used).
Our patient recovered over the next few days after staying at our clinic, and we finally discharged her, advising her to be more careful around bulls or other large animals.
Interesting case that maybe wouldn’t be as typical in the U.S., thanks for reading. Also, a graphic reminder to not get too close to the local bulls!