Bull Horn Research Articles

Bull horn injuries, analysis of 138 cases

Bull horn injuries, analysis of 138 cases

SAPHO Syndrome: About an Observation and Review of the Literature

Introduction: SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) is autoinflammatory rheumatism of the spondyloarthritis group. It is rare, it prevalence is 1/10000 inhabitants. The average age at diagnosis is 38 years, with no gender predominance, first described by Chamot and colleagues in 1987. Objective: To present observation and review of the literature on SAPHO syndrome which is rarely diagnosed in our daily practice. Observation: This was a 28 year old female patient, Senegalese, living in Dakar, followed in obstetrics gynecology for the desire of maternity, the family context of sickle cell disease who consulted for diffuse mechanical and articular inflammatory pains involving the proximal interphalangeal (IPP) of the left 5th toe, the left shoulder, the sternocostal and dorsolumbar joints evolving for 3 years. The clinical examination found: A painful swelling with a visual analog scale (VAS) of 6/10 of the right sternocostal joint and of the interphalangeal joint (IP) of the right hallux, diffuse acne, no palmoplantar pustulosis, no psoriasis, no gluteal or talalgia. The biology shows an inflammatory syndrome (VS at 37 mn at the 1st hour and CRP at 41mg/l), a decrease of 25-OH-Vitamin D3 at 22 ng/ml (N: 25-30 ng/ml), the positive latex test, Ac anti-CCP: 43 IU/ml (N < 5 IU/ml), positive Ac anti-HBc , Ac anti HBs > 1000 IU/l on the other hand blood calcium, blood phosphorus, G6PD, PTH, TSH us, free T4, anti ECT Ac, HLA-B27 Ag with no particularities. The scintigraphy showed hyper fixation of the right 1st toe, sacroiliac joints, dorsolumbar spine, left shoulder, manubrium sternal junction, and bilateral sternoclavicular junction realizing a classical bull horn image in SAPHO syndrome. Because of this clinical and paraclinical manifestation helped by the 1994 diagnostic criteria of Kahn at 1/3 (chronic joint involvement associated with severe acne), the SAPHO syndrome was retained and the treatment instituted after the normal pre-therapeutic analysis and systematic deworming was: Salazopyrine 2000mg/day (dosage reached by increments of 500 mg/week); Uvedose (vitamin D3 ) 100000 IU / month; bisphosphonates 70 mg /week and paracetamol + codeine 1g x 2/day as needed for 3 months with a favorable follow-up by the regression of signs (pain VAS at 2/10). Conclusion: The SAPHO syndrome is the prerogative of the young adult subject, bone scintigraphy is very valuable for its diagnosis, its better knowledge would avoid diagnostic and therapeutic erratic. Keywords: SAPHO syndrome, bone scan, Dakar, Senegal.

Bull horn vascular injuries in popular celebrations: A 40-year retrospective analysis

Objective: The aim of the present study was to analyze and report the clinical presentation and treatment at a single center of bull horn vascular injuries (BHVIs) that had occurred during popular celebrations in the past four decades. Thus, we investigated BHVIs in a high-volume academic center in Spain.

Impact of subnasal lip lift on lip aesthetic: a systematic review.

This study is to perform a systematic review of the literature on surgical correction of the upper lip in order to assess whether the subnasal lip lift technique improves lip aesthetics and maintains its stability. A systematic search was carried out using the PubMed, Science Direct, Scopus, Cochrane Library and EMBASE databases, based on records published until July 2020. The quality of the included studies was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. In the absence of randomized clinical trials, prospective or retrospective cohort studies, case control and case series were considered eligible. Of the 464 articles initially found by the two reviewers, 4 were selected, with 2 retrospective cohorts and 2 case series. The results of the studies showed that 92.4% of subnasal lip lift cases were performed in women with an age range between 21 and 65years (mean of 36.6years). Only one of the 4 studies did not contain information regarding the sex and age of the patients. The bull's horn excision pattern for subnasal lip lift was used to perform the subnasal lip lift in 75% of the included studies. All studies pointed to an improvement in lip aesthetics after the subnasal lip lift, based on anthropometric measures and the degree of patient satisfaction while maintaining results for varying periods of time (from 12 to 59.1months). The studies included in this review suggest that the subnasal lip lift improves lip aesthetics in adult patients and maintains its stability for a certain period of time.

Bull horn vascular injuries in popular celebrations: A 40-year retrospective analysis

ObjectiveThe aim of the present study was to analyze and report the clinical presentation and treatment at a single center of bull horn vascular injuries (BHVIs) that had occurred during popular celebrations in the past four decades. Thus, we investigated BHVIs in a high-volume academic center in Spain. MethodsAll the patients with a BHVI admitted between January 1980 and January 2021 were retrospectively enrolled in the present study. Data collection included demographics, injury profile, and outcomes. The primary outcome was in-hospital mortality. The hospital and intensive care unit lengths of stay, rates of reintervention, postoperative complications, and mortality were also analyzed. Data were collected from the electronic and/or digitized medical history records. ResultsA total of 296 patients were included in the present analysis. The mean patient age was 33.4 years (range, 17-91 years), and 93.9% were men. Of the 296 patients, 126 (42.6%) had experienced a complication, and 57 (19.3%) had required reoperation. The overall in-hospital mortality was 5.1%. The risk factors for mortality were arterial injury (odds ratio [OR], 5.11; 95% confidence interval [CI], 1.45-23.3; P = .009), injury to the abdominal region (OR, 3.45; 95% CI, 1.11-14.54; P = .038), American Society of Anesthesiologists classification IV (OR, 3.27; 95% CI, 1.87-17.83; P = .004), and age >65 years (OR, 3.13; 95% CI, 1.38-10.04; P = .001). Statistically significant differences were found between bull horn arterial injuries and arterial plus concomitant venous injuries in the intensive care unit length of stay (4.9 ± 13.3 days vs 3.1 ± 12.6 days; P = .024), hospital length of stay (12.0 ± 8.2 days vs 10.1 ± 6.3 days; P = .007), postoperative complications (45.2% vs 30.6%; P = .002), and mortality (3.4% vs 1.9%; P = .001). ConclusionsThe morbidity and mortality from BHVIs have remained high for the past 40 years. Popular celebrations with bulls constitute an etiology of vascular trauma that can have dire consequences.

A case of eyelid avulsion injury caused by bull horn

A case of eyelid avulsion injury caused by bull horn

Endourological Management of a Case of Rectourethral Fistula in Post Bullhorn Injury

Bull horn injuries are common in rural India. We hereby report one such case causing urethrorectal fistula and managed endourologically. The patient presented with a history of bull horn injury in the perineum with the inability to pass urine. On examination, under anesthesia, induration in the anus and anterior wall of the rectum was found with passage of urine per rectum. Initially, sigmoid colostomy and suprapubic cystostomy were done. Later, cystoscopy-guided endodilatation, followed by per urethral catheterization was done. The patient was catheterized for 3 weeks and the fistula healed completely.

Eight-year analysis of bullfighting injuries in Spain, Portugal and southern France

Improving knowledge on the epidemiology and analysing the prognostic factors of severity for injuries caused by fighting bulls in Spain, Portugal and southern France. Observational retrospective study including 1239 patients with a reported history of bull horn injuries between January 2012 and November 2019 in Spain, Portugal or southern France. A multiple logistic regression test was used to analyse the prognostic factors of severity and mortality rate of these lesions. The mean accident rate was 9.13% and the mortality rate was 0.48%. The most frequent mechanism of trauma was goring, and the commonest locations of the lesions were thigh and groin. Vascular lesion was found in 20% of thigh/groin gorings. Prognostic factors of severity were vascular lesion, head trauma, fracture, goring injuries and age of the animal. The most reliable prognostic factors of mortality were vascular lesion and goring in the back. Lesions caused by fighting bulls are common in the bullfighting events held in Spain, Portugal and southern France. Although the mortality rate is low, there is a higher morbidity rate, which is conditioned by vascular lesion. All medical teams should include a surgeon experienced in vascular surgery and an anaesthesiologist.

Assessment of sphincter integrity using intraoperative endoanal ultrasound after bull horn injury to the perianal area

Assessment of sphincter integrity using intraoperative endoanal ultrasound after bull horn injury to the perianal area

Análisis de la estructura del cuerno del toro de lidia mediante análisis de imagen. Efecto del enfundado

The Lidia bull honrs are the most important anatomical part of the animal, since it gives it its offensive character and at the same time gives it purity and integrity. Today, in many of the farms, the horn is protected during the last year of breeding with a fiberglass cover. This paper aims to study the internal structure of the fighting bull's horn, analyzing the possible influence of the sheath on it. For this, horns have been collected from 55 bulls (4-5 years), with a group of sheathed individuals of 25 animals. Biometric information has been collected on the horn and the age of the animal. One horn from each animal has undergone an imaging study using radiography, densitometry and magnetic resonance imaging. The radiological study offered great information on the internal structure of the horn, being a good method for evaluating the integrity of the horn. The antlers of the non-sheathed animals presented higher values of bone area, mineral content and mineral density at the level of the distal bone area, which reveals a harmful effect of the sheath. This could lead to a greater predisposition to a eventual fracture, however, no differences between groups were observed in the study performed by magnetic resonance imaging.

Aesthetic Surgical Enhancement of the Upper Lip: A Comprehensive Literature Review

The recent rise in popularity of minimally invasive facial aesthetic procedures has resulted in the overall heightened patient interest in lip rejuvenation. There is a variety of techniques and modifications for surgical upper lip enhancement described in the literature but no single method is considered optimal. The aim of this literature review is to provide a comprehensive analysis of the studies dealing with surgical upper lip enhancement and evaluate their short- and long-term outcomes, as well as complication profiles. A comprehensive review of the published literature through July of 2019 was performed. The PUBMED and Cochrane databases were searched for all English language articles on aesthetic surgical enhancement of the upper lip. Only articles dealing with the aesthetic aspect of the upper lip subunit were included. Preoperative assessment, patient selection and technique execution were assessed. Data were abstracted on all postoperative complications and outcomes. Overall, 52 articles were screened for inclusion, of which 17 met the inclusion criteria. The total number of patients treated in these studies was 2265. The average follow-up period was 30months. The most commonly used surgical method across the studies was the subnasal lip lift (93.6%). The bull's horn excision pattern was utilized to perform the subnasal lip lift in 71.7% of the cases, and the wavy ellipse excision was used in 18.1% of patients. Lip advancement by vermillion border excision pattern was the technique of choice for 49 patients (2.2%). Across all patients the most common complication was a non-aesthetically appealing result or adverse scarring with a mean incidence of 7.23%. Overall, the studies reported improvement in the aesthetic appearance of the upper lip after surgical enhancement, along with few but promising reports of high patient satisfaction. There is a relative paucity of high-quality data regarding complication profiles, patient selection, indications and contraindications. This review provides an overview of several techniques and modifications for upper lip enhancement. It highlights the paucity of high-quality data on their application and optimizing patient selection. Promising satisfaction rates and relatively low complication rates suggest a more prominent role for surgical cheiloplasty in facial rejuvenation. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Traumatic hernia due to a bull horn, sheathed goring

Revista monográfica de cirugía de la pared abdominal, digital y en lengua española. Artículos originales de investigación, editoriales, imágenes clínicas, cartas al director, reseñas de publicaciones, etc.

Pulmonary tractotomy for penetrating pulmonary injuries caused by bull horn: a case report

In our environment, the seriously wounded and injured in the context of the taurine injuries (by definition of high energy) justify an important problem of health. The potential complexity of the situations to be resolved obliges the prioritization in the action. So, to improve the prognosis of the penetrating pulmonary injuries it is absolutely necessary to both know the specificities of this type of injuries such as adapting the initial care protocols to these particularities traumatized serious. The present case reports a multiple and bilateral penetrating pulmonary injuries caused by bull-horn. It is not often that injuries of this magnitude reach the hospital alive, which is why the exceptionality of the case and the challenge that arises. We used endostapler for the management of penetrating pulmonary injuries to perform the tractotomy. After a complicated postoperative period by multiple thoracic and abdominal injuries, the patient could leave the hospital showing full recovery of thoracic wounds. Stapled pulmonary tractotomy allows a rapid, effective, and safe approach to the exposure of bleeding intraparenchymal pulmonary vessels and transected bronchi. This technique can be used without any bleeding from the staple line. We believe that tractotomy can play an important role in treating penetrating lung trauma, specially with multiple or bilateral injuries in the lung and avoid formal resection preserving lung volume and reduces the operative time and blood loss.

Lifting de lèvre et restauration philtrale par le lambeau en moustache

The restoration of the philtrum is an often neglected aspect in the technique of labial lifting with a perinasal scar, or it is secondarily resorted to by simple injections of hyaluronic acid. We are not in favor of the classic continuous bull's horn scar because, on the one hand, we consider that most of the labial shortening is due to the nasal floor resection -the internal excursion of which determines the final result-, and on the other hand that the approximation of 2 skins of very different nature (columella and lip) may cause a visible scar. The base of the columella is particularly well vascularized by the anastomosis of branches derived from the external carotid artery via the superior labial artery and septal branches distributed from the internal carotid system. We therefore consider that this zone on each side of the base of the columella constitutes the vascular pivot of our "mustache flap" drawn according to the classic peri nasal incision: this flap is desepidermized and then totally elevated from the orbicularis muscle except for its internal part where it is simply discarded so as not to compromise its vascularity; it is then rotated at 90° and inserted into a tunnel fitted in the subcutaneous plane down to the red lip corresponding to the restoration of the 2 philtral crests. Thus, all of the superior labial deformations observed over time (elongation and convexity of the white lip, flattening of the philtrum are corrected in a long lasting manner. The intervention is carried out under local anesthesia and, if necessary, the other elements of aging (loss of volume of the red lip, vertical wrinkles, defect of pigmentation etc.) can be corrected without risk at the same time.

A bull gore injury: a rare case report and review of the literature

Background: Bull gore injuries are not common in a city set up but are common in the rural areas. The range of injuries varies from abdominal, chest, scrotal injuries which are quite different from the usual injuries seen in the emergency and casualty like road traffic injuries and stab injuries. We report a rare case of bull gore injury seen in a 38-year-old farmer, managed in this peripheral mission hospital one involving a stray domestic bull, its management as well as review of the literature. It is aimed that the knowledge gained from analyses of these injuries may be beneficial to other clinicians in general and also applicable to the management of similar injuries sustained in rodeo or agricultural settings. Case Presentation: A 38-year-old male farmer of Kumbo origin, Northwestern Cameroon was seen at the emergency department after being hit by a stray domestic bull in his farm. He presented with a complaint of pain in the left iliac fossa, actively bleeding deep laceration in the left inguinal region and a left scrotal swelling. On presentation, his vital parameters (blood pressure: 120/80 mmHg, pulse rate: 82/minute, respiratory rate: 18/minute, temperature: 37.10 Celcius) were stable. On physical examination, the eviscerated left testes and cord was visible at the edge of a deep laceration in the left inguinal region and there was moderate swelling in the left iliac fossa. Rectal examination did not reveal additional finding. The bowel sounds were normal. We made a clinical diagnosis of penetrating abdominal injury with evisceration of left testes. The findings from the initial laboratory studies; Chest and plain abdomen radiographs were essentially normal. Focused abdominal sonography for trauma showed minimal free fluid in the left paracolic gutter and pelvis as well as diffuse hypoechoic mass (hematoma) of anterior abdominal wall essentially in the left iliac fossa. He was resuscitated on intravenous fluids, IV Ceftriaxone 1gm 12hourly, IV Metronidazole 500mg 8hourly, IV Paracetamol 1gm 8hourly. He also had anti-tetanus prophylaxis and was thereafter transferred to the OR. He had exploratory laparotomy, and left groin exploration; extensive left groin wound debridement with evacuation of hemoperitoneum, orchidopexy and wound closure over left pelvic as well as scrotal drains. The post-operative period was uneventful with optimal recovery. The patient was subsequently discharged on the seventh post-operative day and had since been seen in the surgical outpatient clinic at three weekly intervals for six months with satisfactory outcome. Conclusion: Trauma due to animals especially those caused by bull horn could be life threatening as well as leave disability due to the site involvement. Early intervention and trauma surgery can be both lifesaving and could also prevent disability at a later stage. Management of bull gore injury can be challenging to the surgeon who needs have high index of suspicion for the diagnosis of this condition and take a call on type of management. Also, surgical repair of the injury is also difficult because of the complex anatomy and the less accessibility. There is an increasing priority for preventive measures to curtail such mishaps. Keywords: Bull horn Injury; Abdominal Trauma; Bull-Fight; Goring; Evisceration

Fatal bull horn injury-A case report

Fatal bull horn injury-A case report

Surgical correction of hypertrophic upper lip in vascular malformations

Capillary malformations (CMs) and Lymphatic malformations (LMs) are vascular malformations that share a common tendency to cause soft and hard tissue hypertrophy, expressed in the three dimensions of the space. The middle third of the face is the most commonly involved area, with a predominance of the upper lip.To our knowledge, no paper has previously focused on the surgical technique to correct such deformities. We propose and illustrate a surgical protocol, consisting in merging an asymmetric bikini upper lip reduction and a unilateral bull horn resection technique, that allowed to reduce the overall volume of the hypertrophied lip thus restoring lip symmetry. We adopted this technique in 2 patients affected by CMs and 4 patients with LMs, with satisfactory results.

Evisceration of small intestine through thigh due to bull gore injury- A rare case

Bull horn injuries are common injuries in the rural population 1. These types are injuries are seen in farmers who take care of the cattles. Generally the injuries are seen in the perineal area and lower abdomen 2. I am reporting a rare case where there was penetrating injury in the right thigh extending into the peritoneal cavity with evisceration of small intestine though the thigh.

An isolated femoral vein injury caused by bull horn

Introduction Bullhorn injuries have rarely been documented in the literature. Most of the articles are related to the injuries occurred during bullfighting shows and bull-running festivals. Bullfighting is still a popular and uniquely cultural tradition of many Ibero-American countries (Spain, Portugal, Mexico etc.).

A prospective study of chest injuries and associated complications with special reference to surgical emphysema

Background: Chest trauma (or thoracic trauma) is a serious injury of the chest. Thoracic injuries may present extremely dramatic clinical problem that demand rapid diagnosis, decision making and aggressive management. Thoracic injuries can range from simple single rib fracture to major thoracic vessel injury and pulmonary contusion.Objective of this study was to describe the clinical characteristics and risk factors of thoracic trauma patients, and to evaluate their relationship in the development of complications with special emphasis to surgical emphysema.Methods: Descriptive, prospective and analytical study of a cohort of patients with thoracic trauma who were followed up for a period of 30 days. Excluded from the study were those patients with moderate to severe cranio-encephalic trauma, long bone fractures, abdominal trauma, and patients who required mechanical ventilation.Results: A total of 102 patients met the inclusion criteria out of which 90(88.23%)patients were male and 12(11.77%) female with male to female ratio of 7.5:1. Patients having surgical emphysema were all male 21(21.56%). Most common mode of the injury seen was road traffic accidents in 80 (80.95%) patients, followed by assault in 9(9.52%) patients, bull horn injury and fall from height in 4(4.76%) patients. Other chest injury which was most commonly associated with surgical emphysema was haemothorax in 11(52.38%) patients, followed by pneumothorax in 7(33.33%) patients, pulmonary contusion in 6(28.57%) patients and flail chest in 3(14.26%) patients. The risk of complications increases significantly in patients with more than 2 rib fractures, in older patients and in the presence of some comorbidities such as COPD and pathologies that require anticoagulation. The risk of re-admittance is greater in patients older than 60 years.Conclusions: Patients with thoracic trauma who present with co-morbidities, are older than 60 years and have more than 2 ribs fractures may present with more complications. These factors should be contemplated in the evaluation, management and follow-up of these subjects.