Pneumoperitoneum as an uncommon complication after an axillary laceration in a horse.
Abstract: Lacerations of the axillary region occur frequently in horses. Typical complications caused by entrapment of air in the wound during locomotion are subcutaneous emphysema, with consecutive pneumomediastinum and pneumothorax. In this case report, the clinical, radiographic and laboratory diagnosis and management of these complications after an axillary laceration that finally resulted in pneumoperitoneum are described. A 1-year-old Hannoveranian was presented with a pre-existing axillary laceration of unknown duration and subcutaneous emphysema in the surrounding tissue. Due to extensive tissue loss, attempts to adequately close the wound surgically and by packing with sterile dressing material were unsuccessful. Despite stall confinement and tying of the horse, subcutaneous emphysema was progressive and pneumomediastinum as well as pneumothorax was developed. These complications were monitored radiographically. On day 5 after admission, signs of air accumulation were detected on radiographs craniodorsally in the peritoneum and a pneumoperitoneum was diagnosed. Repeated thoracentesis with a teat cannula to gradually evacuate the thoracic cavity was used in combination with nasal oxygen insufflation to treat global respiratory insufficiency. Subcutaneous emphysema and all other complications resolved progressively and the horse was discharged from the hospital 21 days after admission when the axillary wound was adequately filled with granulation tissue. The wound healed fully 1 month later and the horse did not develop long-term complications within the following year. To the authors´ knowledge, the development of pneumoperitoneum including its radiographic monitoring following an axillary laceration has not been described in horses previously.
© 2022 The Authors. Veterinary Medicine and Science published by John Wiley & Sons Ltd.
Publication Date: 2022-01-06 PubMed ID: 34990086PubMed Central: PMC8959331DOI: 10.1002/vms3.718Google Scholar: Lookup
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Summary
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The study is a case report of a one-year-old Hannoveranian horse that developed pneumoperitoneum, a rare complication after an axillary laceration. The paper describes the clinical, radiographic and laboratory diagnosis as well as the management of the particular case.
Background and Purpose of the Study
- The purpose of this study was to document and describe a rare occurrence in horses, where an axillary laceration led to pneumoperitoneum, which is the abnormal presence of air in the peritoneum (the space between the abdominal wall and the organs).
- The researchers were interested in studying the clinical manifestations, diagnosis methods, and treatment procedures for such an unusual complication in horses after a common injury like an axillary laceration.
Case Presentation
- The case in focus was a one-year-old Hannoveranian horse presented with a pre-existing axillary laceration of unknown duration and subcutaneous emphysema (air trapped under the skin) in the surrounding tissue.
- Despite efforts to surgically close the wound and pack it with a sterile dressing, there was significant tissue loss and the wound remained open. The horse continued to develop subcutaneous emphysema, as well as pneumomediastinum (air trapped around the heart) and pneumothorax (air accumulated in the chest cavity).
- These complications were monitored radiographically and on the fifth day, signs of air accumulation were detected in the peritoneum which led to the diagnosis of pneumoperitoneum.
Treatment and Outcome
- The developed complications were treated using repeated thoracentesis – a procedure to remove air from the chest cavity, along with nasal oxygen insufflation to manage the horse’s respiratory distress.
- Subcutaneous emphysema, and all other complications progressively resolved and the horse was discharged from the hospital after 21 days when the axillary wound was sufficiently filled with granulation tissue.
- No long-term complications were reported in the following year of treatment. The fully healed wound was noted one month later.
Conclusions
- The study concluded that pneumoperitoneum can occur as a rare incident after axillary laceration in horses, and it stressed the need for proper radiographic monitoring in such cases.
- The documented case and its treatment contribute to the limited knowledge base regarding such unusual complications in horses, providing insights for potential similar cases in the future.
Cite This Article
APA
Schoen LM, Al Naem M, Röcken M, Geburek F.
(2022).
Pneumoperitoneum as an uncommon complication after an axillary laceration in a horse.
Vet Med Sci, 8(2), 546-552.
https://doi.org/10.1002/vms3.718 Publication
Researcher Affiliations
- Department for Equine Surgery, Justus-Liebig Universität Gießen, Gießen, Germany.
- Department for Equine Surgery, Justus-Liebig Universität Gießen, Gießen, Germany.
- Department for Equine Surgery, Justus-Liebig Universität Gießen, Gießen, Germany.
- Department for Equine Surgery, Justus-Liebig Universität Gießen, Gießen, Germany.
MeSH Terms
- Animals
- Horse Diseases
- Horses
- Insufflation / adverse effects
- Insufflation / veterinary
- Lacerations / complications
- Lacerations / veterinary
- Mediastinal Emphysema / complications
- Mediastinal Emphysema / therapy
- Mediastinal Emphysema / veterinary
- Pneumoperitoneum / complications
- Pneumoperitoneum / therapy
- Pneumoperitoneum / veterinary
- Pneumothorax / complications
- Pneumothorax / therapy
- Pneumothorax / veterinary
- Subcutaneous Emphysema / complications
- Subcutaneous Emphysema / veterinary
Conflict of Interest Statement
The authors declare no conflict of interest.
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