A 44-year-old male was admitted to the Intensive Care Unit (ICU) due to bullhorn trauma, with penetrating wounds in the right groin and popliteal fossa and a non-penetrating injury in the left flank region (Fig. 1). The computed tomography (CT) scan evidenced abdominal wall injury with bowel loop herniation (# in the figure) and grade V traumatic kidney injury (hilar avulsion) on the same side (asterisk). No open wound was observed in that zone – only skin bruising (Fig. 1).

Figure 1

(0.15MB).

In some cases, when the horn is not sufficiently sharp, injuries consistent with penetrating trauma are produced, though the skin remains intact because of its elasticity, producing what is known as a “sheathed goring” injury. The shaded area in the CT scan shows the trajectory of the horn injury, with the hernia being contained only by the skin.

The patient presented an Injury Severity Score (ISS) of 42 and required nephrectomy with herniorraphy. The subsequent course was uneventful.