Closed laceration of the trachea, esophagus and guttural pouches in a mare caused by blunt trauma.

This research article discusses the case of a mare treated for a closed laceration of the trachea, esophagus, and guttural pouches caused by a blunt trauma to the neck.

Case Presentation

• The study details a case of a mare that was admitted to a clinic due to progressive neck swelling, lethargy and anorexia.
• Radiography indicated perilaryngeal, peritracheal, and periesophageal emphysema. Endoscopy, a procedure that visualizes the internal organs, revealed a collapsed pharynx and trachea’s roof, as well as a small cut on the trachea.
• The horse’s condition was caused by an unseen trauma: a hoofprint mark was discovered on the mare’s neck during a tracheostomy, suggesting it had been kicked or stepped on by another horse.

Treatment

• The mare was treated with antimicrobials, fluids, and flunixin.
• To prevent further deterioration of the emphysema – a condition in which air enters the tissues, causing swelling – a temporary tracheostomy was performed: a tube was inserted surgically into the windpipe allowing air to pass.
• Upon a new endoscopic examination, doctors found that the esophagus and the guttural pouch – an air filled structure unique to horses – were also lacerated and communicating with the visceral compartment of the neck, which caused the emphysema.
• On the fourth day after admission, the veterinarian performed an esophagostomy to prevent the flow of feed into the neck, and to allow feeding. This procedure involves making an incision and insertion of a feeding tube into the esophagus.

Complications and Recovery

• The mare faced several complications during recovery, including a deep cervical infection requiring surgical drainage, esophageal impaction which caused extensive mucosa erosion, and laminitis, inflammation in the horse’s hooves, managed with reduced physical activity and corrective shoeing.
• The tracheostomy and esophagostomy tubes were removed 10 and 36 days after admission, respectively, and the mare was discharged 51 days after admission.
• Post-treatment, the mare recuperated well and even returned to competing in children’s showing classes. The study holds that blunt trauma to the neck can cause significant internal lacerations but can be managed with antimicrobials, surgical procedures, and supportive care.