Closed laceration of the trachea, esophagus and guttural pouches in a mare caused by blunt trauma

Abstract

A mare was admitted for progressive swelling of the neck, lethargy and anorexia. Radiography revealed perilaryngeal, peritracheal, and periesophageal emphysema. Endoscopy revealed pharyngeal and tracheal roof collapse, and a small laceration on the trachea. Treatment with antimicrobials, fluids, and flunixin was initiated. To prevent exacerbation of the emphysema, temporary tracheostomy was performed. Clipping for the tracheostomy revealed a hoofprint mark on the ventral neck. Subsequent endoscopies revealed laceration of the esophagus and guttural pouch septum communicating with the visceral compartment of the neck. Four days after admission, an esophagostomy was performed to prevent leakage of ingesta into the neck and allow feeding. Complications occurred: Deep cervical infection requiring surgical drainage; Esophageal impaction with shavings on one occasion causing extensive mucosa erosions; Laminitis managed with restricted physical activity and corrective farriery. Tracheostomy tube removal, esophagostomy tube removal, and patient discharge occurred 10, 36 and 51 days after admission, respectively. The mare did well after discharge and returned to competing in children’s showing classes. Blunt trauma to the neck can lacerate the trachea, esophagus and guttural pouches causing emphysema and deep cervical infection, which can be treated with antimicrobials, temporary tracheostomy, temporary esophagostomy, surgical drainage, and supportive care.