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Gastric Perforation After a Dog Attack.

Hayaki Uchino, Akira Kuriyama, John Bruce

    Pediatric Emergency Care
    |October 18, 2016
    PubMed
    Summary
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    Dog bites can cause severe injuries, even life-threatening intra-abdominal perforations, particularly in children. Prompt surgical repair and prophylactic antibiotics are crucial for managing these devastating pediatric dog bite cases.

    Area of Science:

    • Pediatric Surgery
    • Trauma Surgery
    • Emergency Medicine

    Background:

    • Dog bites are a significant cause of pediatric injury, commonly affecting extremities, head, and neck.
    • Torso injuries are less frequent, with only two reported cases of intra-abdominal injury from dog bites.

    Observation:

    • A 3-year-old boy presented with peritonitis following multiple dog bites to his trunk and upper limbs.
    • Emergency laparotomy revealed peritoneal penetration and a single gastric wall perforation with tooth marks.

    Findings:

    • The gastric perforation was surgically debrided and repaired.
    • The patient received rabies prophylaxis and antibiotics (amoxicillin-clavulanate).
    • The child experienced an uneventful postoperative recovery.

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    Implications:

    • This case highlights the potential for devastating intra-abdominal injuries from dog bites in children.
    • Management principles include wound debridement, prophylactic antibiotics, and rabies postexposure prophylaxis when indicated.
    • Clinicians must recognize the severity of some dog bites and be prepared for complex wound management.