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Camel-related major vascular injuries: A 20-years’ experience

      Highlights

      • Camel-related vascular injuries may have a poor clinical outcome due to the complexity of the biomechanism of injury.
      • Although the skin injuries of camel bites are small, the long canine teeth of a camel can penetrate deeply.
      • The elongated jaws of the camel having strong masseter muscles increases the strength of the bite grip of the canine teeth.
      • The carotid is the most common injured artery because the camel can have a strong grip on the thin regions of its victims like the neck.
      • Neck wounds of camel bites can be closed primarily after debridement.

      Abstract

      Background

      Majority of human animal-related injuries in the United Arab Emirates are caused by camels. These may involve major vessels and can be life-threatening. We aimed to study the biomechanism, injured regions, management, and outcome of major camel-related human vascular injuries.

      Methods

      We retrospectively studied all patients who were admitted to Al-Ain Hospital with camel-related major vascular injury during January 2001 to January 2020. Studied variables included demography, mechanism of injury, injured structures, clinical presentation, vital signs on arrival, associated injuries, surgical management, ICU stay, length of hospital stay, complications, and outcome.

      Results

      Seven patients were studied; all were males having a median age of 26 years. Five out of six bite injuries (83%) occured during the camel rutting season. The injuries were severe and life-threatening. A camel bite causes four small elliptical wounds of the canine teeth which resembles two stab wounds of 8 cm long, penetrating deeply and injuring major vessels. Four involved the carotid artery, one the femoral artery and vein, one the external iliac vein and one the aorta which was due to a fall from a camel. Although the standard of surgical care was high, the outcome was poor. Six patients were admitted to the ICU for a median of 5 days. One patient died, one became vegetative, and one had arm paralysis.

      Conclusions

      Major camel-related vascular injuries have a poor clinical outcome. This is related to the biomechanism of injury which combines penetrating, crushing and blunt trauma. Neck wounds of camel bites can be closed primarily after debridement.

      Keywords

      Abbreviations:

      ATLS (advanced trauma life support), CT (computer tomography), ICU (intensive care unit), PTFE (polytetrafluoroethylene), UAE (United Arab Emirates)
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