Camel-related Major Vascular Injuries: A 20-years’ Experience

Abstract Background: Majority of animal-related injuries in United Arab Emirates are caused by camels. We aimed to study the anatomy, biomechanism and outcome of major camel-related human vascular injuries and correlate them to the camel anatomy and behavior.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. A special protocol was designed to collect the data. An adult 7-year-old male camel skull was prepared and web-based video clips of camel bites to humans were analysed to have an in-depth understanding of the biomechanism of injury.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. 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 was vegetative, and one had arm paralysis. The elongated jaws of the camel having its biting component at the front, and the strong masseter muscles at the back increases the strength of its bite grip. Each 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. Aggressive camels bite repeatedly to kill their victims.Conclusions: Camel-related vascular injuries have a poor clinical outcome. Although the basis of their surgical management is similar to other vascular injuries, their poor outcome is related to the aggressiveness of the attacking camel, the anatomy of its jaw, and its intention to kill. Neck wounds of camel bites can be closed primarily after debridement. Studying these unusual injuries gives an insight into the “one globe one health approach” in which humans interacts with the animals and the environment around them. It important to understand the camel behavior for injury prevention.