Oesophageal injury following blunt or penetrating injury due to road traffic accidents is a rare cause of morbidity and mortality. The outcome of delayed diagnosis of oesophageal injury is mostly life threatening conditions. A 23-year-old female presented with respiratory distress, fever, chest pain and facial deformity, following road traffic accident 15 days back. After evaluation, the patient was diagnosed with septicaemia due to large thoracic oesophageal perforation with left pyothorax. The patient was managed by Video Assisted Thoracoscopic Surgery (VATS) decortication with feeding jejunostomy followed by diversion cervical oesophagostomy. The patient was planned for oesophageal reconstructive surgery electively in follow-up period. After six weeks in the follow-up period, surprisingly large thoracic oesophagus perforation and cervical oesophagostomy was healed spontaneously which was confirmed by gastrograffin study. Spontaneous closure of large thoracic oesophageal perforation is the rare outcome of this injury.

The most common cause of morbidity and mortality worldwide in the age group of 10–49 years is road traffic accidents. Other than road traffic accidents multiple other factors add to the burden of injuries which include self-harm, occupational hazards, animal attack injuries and industrial accidents. Animal attack injuries are seen all over the world. Other than a few case reports and case series, this mode of injury is highly under-reported. Hence, the global burden of this disease is unknown. Due to the rapid deforestation, the number of animal attack injuries is increasing. These injuries can be caused by wild as well as domesticated animals. The attack can be due to a direct encounter with an animal or due to road traffic accident. Bulls are ferocious animals that are used for sporting events. They are also used for farming and livestock rearing. Injuries caused by bulls can be due to direct attacks by an unprovoked animal, road traffic accidents, or sporting events. The penetrating injury caused by the bull horn has its characteristic pattern. Treatment of bull horn injuries requires a multidisciplinary team. Creating awareness and enforcing laws can help in preventing such injuries.