Esophageal perforation diagnosis, treatment, complications, and outcome in a Standardbred colt.
Authors: Albrecht Myriah, MacGillivray Katherine Cole, Juez Beatriz, Freeland Russell
Journal: Journal of equine veterinary science
Summary
# Editorial Summary A 4.5-month-old Standardbred colt with acute neck swelling and fever was diagnosed with full-thickness oesophageal perforation via endoscopy and contrast radiography—a rare and typically catastrophic condition in equine practice. Surgical management involved bilateral fasciotomies and placement of an oesophageal feeding tube, combined with prolonged postoperative care including broad-spectrum antimicrobials, gastroprotectants, probiotics, and meticulous site lavage protocols. Despite serious complications including recurrent bilateral pneumothorax and incomplete fistula formation at the oesophagostomy site (requiring primary closure), the colt achieved full clinical recovery within 12 months, maintaining excellent body condition and growth rates appropriate for his age. The case demonstrates that aggressive surgical intervention coupled with intensive nutritional management—calculated specifically to support normal foal growth and development—can yield successful outcomes in young stock, challenging the traditionally poor prognosis associated with oesophageal perforation. For practitioners managing similar cases, this report suggests that tube feeding strategies allowing continued caloric intake are critical to survival, and that accepting short-term complications may be justified when long-term athletic function and market value can be preserved.
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Practical Takeaways
- •Esophageal perforation in young foals can be successfully managed surgically with intensive post-operative care, even with significant complications, allowing return to athletic function
- •Appropriate nutritional management via esophagostomy can support normal growth and development in affected foals despite the intensive dietary demands of growing animals
- •Monitor closely for pneumothorax and fistula formation as post-operative complications; esophagostomy site care and gradual feeding tube removal protocols are critical to minimize secondary fistula
Key Findings
- •Full-thickness esophageal perforation in a 4.5-month-old colt was successfully managed with surgical intervention including fasciotomies and esophageal feeding tube placement
- •Post-operative complications included recurrent bilateral pneumothorax and incomplete fistula formation at the esophagostomy site requiring primary closure
- •The colt achieved full recovery within one year with normal growth rates, excellent body condition, and successful athletic training suitable for yearling sale