Pattern and Outcome of Bull Gore / Bull Related Injuries Presenting to the Emergency Department: Rural Tertiary Care Centre in South Tamil Nadu

Background: Jallikattu is an ancient bull-taming sport in Tamil Nadu. While culturally significant, it is associated with frequent bull gore injuries. Despite high incidence during festival seasons, systematic rural data remain scarce. To Aim: evaluate the pattern, severity, clinical outcomes, and emergency care burden of bull gore and bull-related injuries in a rural tertiary care centre in South Tamil Nadu. This prospective observational study was conducted in the Emergency Department of Methods: Government Sivagangai Medical College & Hospital, Tamil Nadu, between September 2023 and February 2025. All patients with bull gore injuries were included (n = 548). Data on demographics, event type, role (tamer, spectator, raiser, bystander), triage classification (TAEI system), anatomical injuries, surgical referrals, and outcomes were analyzed using SPSS. total of 548 patients were included. Ma Results: jority were male (95%), aged 18–40 years (66%). Roles: tamers 53%, spectators 24%, raisers 22%. Velivirattu (open-field chasing) accounted for 53% of cases and all six deaths. Injuries: extremity soft tissue (42%), thorax (22%), head/neck (17%), abdomen (12%), perineum (8%), fractures (6%). Triage: Red 20%, Yellow 42%, Green 37%, Black 1%. Management: suturing/dressing 75%, ICD 12%, laparotomy 4%; referrals included CTVS, neurosurgery, vascular, plastic, and surgical gastroenterology. Outcomes: 87% discharged, 11% referred, 1% deaths (n=6), 1% LAMA. Spectators had the highest mortality burden. Bull gore trauma poses a predictable but preventable burden in Tamil Nadu. Velivi Conclusion: rattu is the riskiest event, particularly for spectators. Mortality was strongly linked to delayed hospital transfer, lack of PPE, and inadequate trauma preparedness. Policy interventions including PPE, structured arenas, insurance schemes, and ATLS-trained onsite trauma teams are essential to reduce preventable deaths and DALYs while preserving cultural heritage.