Subcutaneous emphysema from an axillary wound that resulted in pneumomediastinum and bilateral pneumothorax in a horse.

This research article discusses a case where a horse developed a life-threatening condition called pneumothorax as a result of a minor axillary wound leading to extensive subcutaneous emphysema.

Presentation of Case

• The research delves into the case of a 5-year-old Thoroughbred gelding which displayed subcutaneous emphysema, an abnormal accumulation of air under the skin, following a small axillary wound incurred 5 days prior. This condition initially seemed to be of minor concern, however, it began to cause respiratory distress in the horse within a few days.

Progress of the Condition and Intervention

• Three days following the infliction of the wound, the horse’s respiratory rate escalated to 72 breaths per minute and the horse exhibited signs of distress. After performing thoracic radiography, the medical team identified a pneumomediastinum – air in the mediastinum, the central compartment of the thoracic cavity – and severe bilateral pneumothorax – the presence of air in both sides of the pleural space, leading to collapsed lungs.
• As immediate medical intervention, tube thoracostomy was conducted on both thoraxes to drain the air. The drains were attached to one-way suction valves and suction devices for thoracic decompression. In addition, they began oxygen insufflation through a nasopharyngeal catheter and restrained the horse to limit movement. The initial wound was also treated and packed.

Resolution and Conclusion

• The treatment proved successful, with the horse showing signs of improvement within 30 minutes. After 15 days, the pneumothorax had resolved fully, the wound had healed and the subcutaneous emphysema had reduced significantly.
• The study primarily underlines that while subcutaneous emphysema is typically regarded as a temporary condition causing cosmetic disfigurement, it could potentially result in serious complications like pneumothorax. It thus suggests the need for confining horses with subcutaneous emphysema and rigorous monitoring to prevent the development of pneumothorax.