Subcutaneous emphysema in a neonatal foal.

This research article talks about a neonatal foal (16-hour-old) diagnosed with subcutaneous emphysema (air trapped under the skin), which developed 3 hours after birth despite an uneventful delivery. Medical examination revealed no soft-tissue damage, musculoskeletal trauma, or skin injuries. After a series of tests and thoracic radiography, other related conditions were found which led doctors to diagnose the patient with primary subcutaneous emphysema. The condition was eventually resolved over 8 days with the help of supportive care and a tracheostomy tube.

Diagnosis of Subcutaneous Emphysema in the Foal

• The foal was brought in for an examination because of a noticeable subcutaneous emphysema. This condition began developing three hours after a routine delivery.
• The physical examination did not reveal any soft-tissue damage or musculoskeletal trauma, and there were no visible skin injuries to explain the subcutaneous accumulation of air.
• A battery of relevant tests including a Complete Blood Count (CBC) and serum biochemical analysis was conducted, which turned out to fall within expected limits.
• Findings on endoscopy of the pharyngeal area, trachea, and esophagus were within normal limits, apart from the observation of dorsal pharyngeal compression.
• Thoracic radiography revealed the presence of a pulmonary bulla, pneumomediastinum, and pneumothorax (conditions related to the accumulation of air in the chest cavity).

Treatment and Outcome

• Given the association of the foal’s symptoms with thoracic abnormalities, a diagnosis of primary subcutaneous emphysema was made.
• A tracheostomy tube (a tube inserted in the neck to enable breathing) was placed to facilitate ventilation and to provide an exit point for the trapped air.
• Supportive care was provided alongside to help the foal recuperate.
• The foal’s condition gradually improved and was completely resolved over the subsequent eight days.