Cattle Prod

 When I use the term "cattle-prod" I normally think of the electrically-powered stick some farmers used to guide errant cows - a bit like a mobile electric fence. I am not very up to date with veterinary issues, but I suspect the use of these is now frowned upon due to animal rights issues. 

I was forced to rethink this concept however when a Cambodian farmer was brought into the accident department in severe pain having been impaled by a cow's horn a few hours earlier whilst she had been stooping down to pick something off the ground.  She was unable to explain what had triggered the attack from her normally docile cow unless it just couldn't resist the target so presented. The unfortunate lady in her 40's had a deep laceration immediately adjacent to her anus - see photo. (I avoided referring to this as a bullseye) which, on subsequent exploration, was confirmed to extend into her rectum. It had also damaged her anal sphincters. The shock of receiving an injury like this was bad enough but, as she was alone and in an isolated field at the time of the injury, she was forced to drive on her motor scooter over bumpy tracks back to her house, which must have been an agonising experience, before she was able to seek medical assistance.

 We undertook  a debridement of the wound with closure of the rectal laceration and repair of both her internal and external sphincters and performed a defunctioning colostomy while the wounds healed. To everyone's delight, including her daughter who was a medical student, once we had closed the colostomy six weeks later, she confirmed that she was continent of faeces and appeared none the worse for the experience apart from an ugly scar that few people are ever likely to see.