Camel-related pancreatico-duodenal injuries: A report of three cases and review of literature

Abstract

Background: Human pancreatico-duodenal injuries caused by camels are extremely rare. Objective: We report three patients who sustained camel-related pancreatico-duodenal injuries and review the literature on this topic. Results: A 32-year camel caregiver was kicked by a camel which then stepped on his abdomen trying to kill him. The patient's abdomen was soft and lax. CT scan of the abdomen showed free retroperitoneal air. Laparotomy revealed a complete tear of the anterior wall of the second part of duodenum which was primarily repaired. A 40-year camel caregiver was directly kicked into his abdomen by a camel. He developed traumatic pancreatitis which was treated conservatively. A 31-year-old male fell down on his abdomen while riding a camel. Abdominal examination revealed tenderness and guarding. Abdominal CT Scan showed complete transection of the neck of the pancreas which was confirmed by laparotomy. The patient had distal pancreatectomy with preservation of the spleen. All patients were discharged home in good condition.Conclusion: These cases demonstrate the misleading presentation of the camel-realted pancreatico-duodenal injuries and their unique mechanism of injury.

The nature and consequences of camel-related injuries: A scoping review with special reference to Arab Middle Eastern countries

“…This form of tibial fracture was regarded as distinctive among camel jockeys and is a common injury [9] . Also, Camel falls can occasionally result in intra-abdominal injuries though they are extremely rare [63] .…”

“…A camel may also kick with its front knees when kneeling [ 16 , 57 , 63 , 70 ]. Abdominal injuries occur in 20% of those kicked and may include trauma to the duodenum and pancreas with subsequent traumatic pancreatitis [63] . The initial trauma may be exacerbated if the attacking animal then stands on the victim.…”

Editorial: Non-communicable diseases are reaching epidemic proportions: evidence from low and middle income countries

“…30 The section on surgery and the GIT includes several interesting papers on factors affecting mortality of critical care trauma patients 31 ; sarcoma of small bowel mesentery simulating hyper immune splenomegaly syndrome 32 ; and upper GI bleeding among neonates 33 . There are more papers on use of a drain after thyroid surgery 34 ; effect of bupivacaine on pulmonary function after elective lower abdominal operations 35 ; camel related panceatico-duodenal injuries 36 ; and postoperative pain in the first 48 hours. 37 Finally we have a section on substance abuse and the health system including: alcohol and substance use among adolescents in Ibadan, 38 smokeless tobacco and tooth loss 39 ; and substance use correlates of relapse among patients treated for addiction.…”

Invited Editorial

“…7,14 In contrast, the camel may lift the victim up by its canine teeth, crushes the body by the jaw, and throws the victim away to hit the ground, and may even later step on the patient. 1,3,4,15 Using a muzzle to cover the camel mouth can prevent bite injuries before they occur.…”