Iatrogenic tracheal rent in a Clydesdale colt

Abstract

A one-month-old Clydesdale colt presented for bilateral scrotal hernia and a patent urachus. Manual reduction of the hernia followed by castration and primary closure of the superficial inguinal rings bilaterally was performed. The umbilical stump was resected along with the apex of the bladder, and the abdomen was closed routinely. During the procedure, the anaesthetist noted difficulty maintaining an appropriate anaesthetic plane. Diagnostics while under general anaesthesia including arterial blood gas evaluation revealed a blood pH of 7.190 and 7.220. In addition, a large mass was noted in the ventral cervical region that was not present prior to surgery. The mass dramatically reduced in size as the endotracheal cuff was deflated. Postoperatively a tracheal rent was identified, and a temporary tracheostomy was performed under endoscopic guidance. The colt was maintained on systemic antimicrobials, NSAIDs and gastric ulcer prophylaxis and was discharged without complication four weeks later.

Mortality and morbidity in equine anaesthesia

“…Overinflation of the cuff may cause tracheal mucosal sloughing (Jago et al 2015) or a tracheal tear (Little 2015). Secondary bacterial infection causing tracheal necrosis (Wylie et al 2015) and pleuropneumonia (Rainger et al 2006) may be fatal.…”

Extubation failure and surgical removal of a lodged endotracheal tube in a Welsh Mountain Pony

“…Even though endotracheal intubation complications in horses have been described in the literature, they are likely underreported (Trim, 2015) and are limited to case reports or series including a tracheal rent (Little, 2015), tracheal perforations (Saulez et al, 2009), tracheal necrosis (Wylie et al, 2015) and tracheal rupture following intubation (Miller & Auckburally, 2020). Tracheal complications vary in severity from mild, self‐resolving mucosal changes (Holland et al, 1986) to fatal tracheal necrosis (Wylie et al, 2015) or perforation (Saulez et al, 2009).…”