Dog Bite – A Rare Cause Of Oesophageal Injury

Abstract

Introduction Though rabies has been successfully controlled in some provinces, dog bite is a common problem encountered in the Accident and Emergency (A & E) departments of South Africa. In our experience, dog bites are usually from police dog units or a neighbour’s dog. Oesophageal injury is very lethal if not treated early. Morbidity & mortality are directly related to the time that elapses from the time of injury and a comprehensive knowledge about bite wounds management is essential. Case presentation On the 3rd of November 2004, a 7year-old boy was attacked by the neighbour’s dogs when he entered the premises in the company of other boys. The child was brought to our A & E department in psychogenic shock. He had a low blood pressure (80/50 mmHg) on presentation and a Glasgow Coma Scale of 9/15, normal papillary reactions & no external evidence of head injury. It was observed that he had disembowelment from one of the bite area in the abdomen (Figure 1), with perforated small bowel, leaking contents & gray color foodstuffs leaking from one of the neck wounds (Figure 2). His general condition improved on resuscitation and was taken to the theatre for laparotomy and exploration of the neck wound, without any unnecessary delay in A & E dept.