Man versus wild: A case report of a bear attack with thoracic complications

Bear attacks on humans are rare and are even more rarely reported in medical literature. Each year people have numerous accidental interactions with bears around the world. In India, bear attack incidences have been reported in and around Kashmir and in Central India. A very small fraction of these bear attacks result in human injury. Injuries due to bear attacks include skin lacerations, bites etc. The most common areas of injury are the face, legs and hands. Thoracic injuries due to a bear attack hasn't been reported earlier. We present the case of a 55 year old with bear attack, suffered among other injuries, a right Hemo-Pneumothorax. A flail segment was also noted on the right anterolateral region. The patient did not need any invasive ventilation. Right Inter-costal Drain tube inserted ICD drain was discontinued on day 4 of admission. Post drain removal a subcutaneous collection was noted on the back with suspicious pleural tear near the 12th rib detected on MRI. ICD was re-inserted and the patient, conservatively managed. Bear attacks are rare in India, and thoracic injuries causing a flail segment, pleural tear and a hemo-pneumothorax hasn't yet been reported. This case report hence, highlights the fact that bear attacks, like a blunt/penetrating trauma can provide with a challenging scenario in the emergency room. Right knowledge and stepwise management of these cases can therefore ensure complete and wholesome treatment, even in cases with thoracic injuries.