[Intrathoracic esophageal perforation of unknown cause in four horses].

The study documents the identification of esophageal perforation in four horses, brought in for treatment of varying symptoms, all of which had to be euthanized due to the severity of their conditions. Post mortem examinations confirmed the diagnosis in all cases.

Case Details and Initial Symptoms

• The first three horses (17-23 years old) were referred to the equine clinic at the University of Berne with symptoms including colic, fever, rapid heartbeat and respiration. They all had pleural effusion, which is an excessive accumulation of fluid in the lung’s pleural space.
• Clinical findings indicated a possible esophageal perforation in two of the horses, whereas in the third horse, severe septic pleuropneumonia without an evident esophageal lesion was diagnosed.
• The fourth horse, an 11-year old stallion, was referred to the clinic due to suspected large colon impaction. This was treated by administering laxatives via a nasogastric tube.

Clinical Progression and Diagnosis

• The stallion’s condition drastically declined after nasogastric intubation, showing symptoms of severe pleuropneumonia. This suggested that an esophageal perforation might have occurred while the nasogaic tube was being inserted.
• All four horses had to be euthanized as their condition and prognosis were serious.
• Post mortem examination of all four cases confirmed the diagnosis of esophageal perforation and revealed hypertrophy (or enlargement) of the muscular layer (tunica muscularis) of the intra-thoracic esophagus in three of the four horses.

Concluding Observations

• This research brings attention to esophageal perforation as a possible complication during medical interventions, such as nasogastric intubation.
• The observed hypertrophy of the tunica muscularis might be a significant factor to take into consideration in the diagnosis or treatment of esophageal perforation.