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Abstract
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A previously healthy 12-year-old boy was rushed by ambulance to the emergency department with a traumatic left shoulder disarticulation.
Several hours prior to arrival the boy had been swimming with friends in a brackish bayou stream in rural southeastern Louisiana. On exiting the water, an alligator 10 ft in length came ashore, grabbed the boy’s left arm, and pulled him back into the water. The boy’s friend was successful in freeing him from the alligator, but unfortunately his left extremity was traumatically avulsed at the shoulder. The alligator was sacrificed and the boy’s arm recovered from the reptile’s stomach. The boy was transported from an outside hospital to a tertiary care center by careflight, where arm reimplantation was attempted. Unfortunately, the avulsion-type amputation at the level of the brachial plexus and the location of the amputation through the epiphysis at the growth plate prevented reimplantation. Additionally, the recovered arm had sustained multiple bites, contained muscle contaminated with the stomach contents of the alligator, and had already been infested with worms.
Unfortunately, alligator bites occur somewhat regularly, especially in parts of the southern United States where alligators are endemic, such as Louisiana and Florida. The sheer size and power of alligators can lead to extensive tissue damage and injury as the result of an attack. Additionally, these injuries can become infected with a wide array of pathogens—those that inhabit the oral cavity of the reptiles and those that contaminate the bayous and brackish ponds in which they live. |