A Case of Recto-Vesico-Cutaneous Fistula Following Perineal Injury by Wild Boar

Abstract

It is very uncommon for a boar to become aggressive in nature against human unless they are cornered. A wild boar attacked a 24-yearold male from behind in perineal region. At presentation, he had continuous dribbling of urine and fecal matter from perineal wound. On CT-scan, a well defined tract delineated by contrast was seen between postero-lateral aspect of bladder and anterior wall of rectum, and there was contrast extravasation through perineal wound. After resuscitation, fistula was repaired through abdominal approach, and perineal wound was debrided. Emergency physician should be aware of such cases as increasing deforestation and shifting of humans to sub-urban area, have resulted in increased incidences of wild boar attack. Prompt stabilization of patient, treatment of infection with proper antibiotics, prevention of tetanus and rabies infection and emergency surgical interventions are necessary to reduce morbidity and mortality from such trauma.

Keywords

• exploratory laparotomy
• diversion colostomy
• perineal wound