Crocodile bites lead to fatal and nonfatal outcomes in humans. Mugger crocodiles (Crocodylus palustris) and saltwater crocodiles (Crocodylus porosus) are common in India. Most crocodile bites can cause severe injuries, especially
to the extremities, due to the substantial bite force of the crocodile, which typically
leads to extensive tissue damage, fractures, amputations, and vascular injuries. We
report the case of a crocodile bite victim who presented with features of acute limb
ischemia, was found to have vascular thrombosis of the common femoral artery, and
was experiencing complete compression of the femoral vein due to external vascular
compression by a hematoma. We discuss various injury mechanisms sustained in crocodile
bites and the roles of point-of-care ultrasound and continuous tomography angiography,
which could help identify these injuries. After thrombectomy and hematoma evacuation
the patient recovered and was discharged without any physical dysfunction.
Keywords
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References
- Crocodile attack in Australia: an analysis of its incidence and review of the pathology and management of crocodilian attacks in general.Wilderness Environ Med. 2005; 16: 143-159
- An epidemiological study of animal bites in India: results of a WHO sponsored national multi-centric rabies survey.J Commun Dis. 2006; 38: 32-39
- South Asia and Iran: Simon Pooley. A bibliography of human-crocodile conflict research and reports. 3rd ed. London.2016: 25-27 (Available at: https://www.researchgate.net/publication/340342477_Croc_Digest_A_Bibliography_of_Human_Crocodile_Conflicts_3rd_ed.)
- Human crocodile conflict on the Cauvery river delta region, Tamil Nadu, south India.Int J Fish Aquat Stud. 2020; 8: 1-5
- Insights into the ecology and evolutionary success of crocodilians revealed through bite-force and tooth-pressure experimentation.PLoS ONE. 2012; 7e31781
- Crocodile bite injury in southern Malawi.Trop Doct. 1998; 28: 221-222
- Prehospital antibiotics in the ambulance for sepsis: a multicentre, open label, randomised trial.Lancet Respir Med. 2018; 6: 40-50
- Empiric antibiotic treatment reduces mortality in severe sepsis and septic shock from the first hour: results from a guideline-based performance improvement program.Crit Care Med. 2014; 42: 1749-1755
- Time to administration of antibiotics and mortality in sepsis.J Am Coll Emerg Physicians Open. 2021; 2e12435
- Dead or alive? Factors affecting the survival of victims during attacks by saltwater crocodiles (Crocodylus porosus) in Australia.PloS One. 2015; 10e0126778
- Ward round -- crocodile bites in Malawi: microbiology and surgical management.Malawi Med J. 2009; 21: 29-31
- Crocodile attacks in the northern territory of Australia.Med J Aust. 1992; 157: 751-754
- Initial antibiotic therapy for alligator bites: characterization of the oral flora of Alligator mississippiensis.South Med J. 1989; 82: 262-266
- Western trauma association critical decisions in trauma: management of the mangled extremity.J Trauma Acute Care Surg. 2012; 72: 86-93
- Objective criteria accurately predict amputation following lower extremity trauma.J Trauma. 1990; 30 (discussion 572–573): 568-572
- The validity of the mangled extremity severity score in the assessment of upper limb injuries.J Bone Joint Surg Br. 2005; 87: 1516-1519
- Advanced imaging in acute and chronic deep vein thrombosis.Cardiovasc Diagn Ther. 2016; 6: 493-507
- It’s not all deep vein thrombosis: sonography of the painful lower extremity with multimodality correlation.J Ultrasound Med. 2019; 38: 1075-1089
- African Nile crocodile bite of the forearm: a case report.East Afr Orthop J. 2020; 14: 102-107
- External iliac artery thrombosis following open reduction of acetabular fracture: a case report and literature review.Arch Orthop Trauma Surg. 2020; 140: 481-485
- Fecal impaction as a cause of acute lower limb ischemia.Am J Gastroenterol. 1995; 90: 2055-2057
- Compression of the common femoral artery by a lymphangioma causing intermittent claudication.Ann Vasc Surg. 2009; 23 (e11–4): 412
- Intermittent claudication due to right common femoral artery compression by a solitary neurofibroma.Eur J Pediatr. 2005; 164: 463-465
- Traumatic right common femoral artery occlusion caused by blunt bicycle handlebar injury: a case report.Surg Case Rep. 2019; 5: 64
- The motor-scooter-handlebar syndrome.Lancet Lond Engl. 1968; 2: 1051-1053
Article info
Publication history
Published online: July 18, 2022
Accepted:
May 11,
2022
Received:
June 20,
2021
Identification
Copyright
© 2022 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.