Closed laceration of the trachea, esophagus and guttural pouches in a mare caused by blunt trauma.
Authors: Lopes M A F, Hollenbach E, Schliewert E C, Murphy M A, Corrêa F
Journal: Journal of equine veterinary science
Summary
# Editorial Summary A mare presented with acute neck swelling, depression and anorexia following blunt trauma (identified retrospectively as a hoofprint injury to the ventral neck), which had caused simultaneous lacerations to the trachea, oesophagus and guttural pouch septum with resulting subcutaneous, perilaryngeal and periesophageal emphysema. The clinical team managed this complex injury through a staged approach: immediate medical stabilisation with antimicrobials and NSAIDs, temporary tracheostomy to prevent progressive emphysema, and later oesophagostomy (day 4) to redirect ingesta away from the damaged oesophagus and cervical tissues, alongside surgical drainage when deep cervical infection developed. The mare required 51 days of intensive care before discharge, with secondary complications including deep cervical infection, oesophageal impaction with bedding material causing mucosal erosions, and laminitis managed through restricted exercise and corrective farriery. Despite the severity of multi-organ trauma to the neck, aggressive intervention and meticulous supportive care—including nutritional management via the oesophagostomy tube and careful monitoring to prevent bedding aspiration—allowed complete recovery and return to ridden competition. This case illustrates that concurrent tracheal, oesophageal and guttural pouch injuries from blunt cervical trauma are survivable with appropriate surgical and medical management, though clinicians should anticipate potentially prolonged convalescence and secondary complications including infection and laminitis.
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Practical Takeaways
- •Suspect tracheal, esophageal, and guttural pouch injury in any mare presenting with neck swelling, emphysema on radiographs, and history of blunt neck trauma; endoscopy is essential for diagnosis.
- •Temporary tracheostomy is a vital intervention to prevent exacerbation of emphysema during healing of tracheal lacerations.
- •Esophagostomy should be considered early to prevent ingesta leakage into neck tissues and deep cervical infection when esophageal laceration is confirmed.
Key Findings
- •Blunt neck trauma from a hoofprint caused simultaneous laceration of trachea, esophagus, and guttural pouch septum resulting in extensive emphysema.
- •Temporary tracheostomy and esophagostomy combined with antimicrobials and surgical drainage successfully managed the injury despite multiple complications.
- •The mare recovered completely with tracheostomy tube removal at 10 days, esophagostomy tube removal at 36 days, and discharge at 51 days, returning to competitive performance.