Surgical treatment of a traumatic oesophageal rupture in a foal.

This research journal article discusses a case study involving the surgical repair of a traumatic oesophageal rupture in a 12-day-old Standardbred filly (a young female horse). The rupture occurred after the foal was kicked on the neck by a stallion, and successful surgical treatment is described.

Case Overview

• The foal was presented to the clinic with a draining fistula (a connection between the oesophagus and the skin of the neck) that started to discharge four days after the incident.
• A physical examination indicated the foal was alert, well-hydrated and showed no signs of oedema or inflammation around the wound. The presence of milk and saliva escaping through the wound while the foal was sucking suggested an oesophageal injury.
• An oesophageal tube was inserted and palpated directly via the wound, providing confirmation of the suspected diagnosis.

Anesthetic Procedure and Identification of Injury

• The foal was anesthetized, intubated and connected to a semi-closed circuit to maintain anesthesia throughout the procedure.
• A skin incision was made to expose the site of the injury. Accumulated milk and saliva were found around the oesophagus and removed by aspiration.
• The injury consisted of clean, longitudinal wounds on both the ventral (frontal) and dorsal (back) walls of the oesophagus.

Surgical Repair

• After debridement (removal of damaged tissue), the wounds on the oesophageal walls were sutured using different types of sutures for the different tissues.
• A silastic stomach tube was placed and sutured to the nasal mucosa, to allow feeding while the foal was healing. A drain was also fitted in the wound.
• Post-surgery, the foal was muzzled and fed mare’s milk every four hours for six days. Access to solid food was restricted for two more weeks to allow the wound to heal.

Post-Surgical Observation and Outcome

• The oesophageal wound healed by primary intention (healing without complications), and the foal was discharged 16 days after the operation.

Discussion and Recommendations

• While small penetrating oesophageal wounds can heal spontaneously, larger wounds need to be sutured to avoid complications such as a permanent fistula or stricture (narrows in the tube) of the lumen.
• It’s also essential to remove any food or saliva have accumulated around the oesophagus in the case of external trauma, and ensure the wound is carefully cleaned and efficiently drained.
• With a clean wound, primary healing without disruption of the suture line, stricture or dilation is likely. However, in contaminated wounds with friable edges, sufficient debridement or excision is needed to avoid wound breakdown.