Bull horn injuries. A 40-year retrospective study with 572 patients

Although bullfighting festivals were traditionally attributed to the cultural idiosyncrasies of the Ibero-American people, they also exist world-wide. A retrospective study was conducted, reviewing the medical records of patients treated on our service for bull horn injuries between January 1978 and December 2019. There were 572 admissions due to bull horn injuries. 54 of these patients had multiple injuries. The average annual admission was 13.6 patients. The most frequent injuries were located in the lower extremities, perineum, and abdomen. Forty-seven laparotomies were performed, revealing intra-abdominal visceral impairment on 39 occasions. The most frequently injured organs were the intestine and liver. The most frequent complications were skin devitalisation, infection and post-operative eventration. The recorded mortality was 0.87%. We wish to highlight the importance of injuries caused by bull horns worldwide. These are high-impact injuries with specific intrinsic characteristics that require regulated medical and surgical care. •The presence of wild bulls in different countries around the world, and their behaviour in the various environments, highlights the global importance of having a knowledge about possible attacks by these animals and consequent injuries in humans.•The province of Castellon (Valencian Community, Spain) is considered one of the regions with the most bull-related activities worldwide, with more than 5000 popular events held every year.•Between January 1978 and December 2019, a total of 572 admissions were recorded in the General and Digestive Surgery Department of the HGUCS with a diagnosis of ’bull horn injury’.•The average annual admission was 13.6 patients. The most frequent injuries were located in the lower extremities, perineum, and abdomen . Forty-seven laparotomies were performed, revealing intra-abdominal visceral impairment on 39 occasions. The most frequently injured organs were the intestine and liver. The most frequent complications were skin devitalisation, infection and post-operative eventration. The recorded mortality was 0.87%.•Bull horn injuries are high-impact lesions with specific intrinsic characteristics that require regulated medical and surgical care.