A Case of Chest Impalement Injury and Lung Injury Caused by the Horn of a Bull

Abstract

Impalement injury is an open injury caused by a relatively blunt structure other than a knife and is relatively rare. An open injury caused by a cow horn is an example of impalement injuries. We report a case of video-assisted thoracic surgery for a chest wound and a lung injury caused by the horn of a bull. A 41-year-old man was horned by a bull with the weight of about 1,000 kg and was bounced to a height of about 3 m. He was brought into our hospital by ambulance with a wound in the right chest and the right thigh. Emergency surgery was performed for right traumatic hemopneumothorax and lung injury caused by the right thoracic impalement injury. First, thoracoscopy showed a free bone fragment of the third rib to have stabbed in the upper lobe of the right lung. A 4-cm incision was made directly above the third rib to remove this fragment. We then sutured and repaired the lung injury. The postoperative course was good, and the patient was discharged on independent gait on the 11th postoperative day. We report this case of chest trauma caused by a rare implement injury treated by surgery, with a review of the literature.