Laparoscopic diagnosis of subcapsular splenic hematoma in a horse.

This paper recounts a case where laparoscopic technique was found to be effective in diagnosing a 5-year-old Quarter Horse’s subcapsular splenic hematoma, formed due to a training accident. The diagnosis via laparoscopy also enabled the clinicians to formulate an appropriate treatment plan.

Case Presentation

• The horse developed abdominal discomfort after a training accident. The pale oral mucous membranes and extended capillary refill time were the primary signs noticed in the examination.
• Further tests revealed a low packed cell volume (PCV), indicating that the horse was potentially anemic, and abdominocentesis yielded a mix of blood and clear fluid.
• Abdominal ultrasonography demonstrated a large mass of low echogenicity associated with the front edge of the horse’s spleen. The exact nature and extent of this hematoma was unclear, necessitating further investigation.

Laparoscopic Examination

• While the horse was standing, an abdominal laparoscopy was carried out to better understand the splenic hematoma. During a laparoscopy, a small incision is made and a laparoscope, a long, thin tube with a high-intensity light and a high-resolution camera at the front, is inserted to examine the organs within the abdomen.
• The laparoscopic examination revealed a 7.5-centimeter diameter hematoma within the splenic capsule. This was indicative of a subcapsular splenic hematoma, where blood accumulates beneath the outer covering of the spleen. This detailed information assisted the clinician in confirming the diagnosis.

Clinical Significance

• The use of laparoscopy provided a clear visualization of the spleen, allowing a comprehensive evaluation of the size and extent of the lesion. This data was crucial in confirming the nature of the hematoma.
• This diagnostic method is also beneficial in helping clinicians decide the best course of treatment, in this case, between surgical removal of the spleen (splenectomy) and medical treatment.