Successful treatment of a splenic abscess secondary to migrant metallic wires in a horse

Abstract

Summary This case report discusses a successful partial splenectomy for treatment of a splenic abscess in a horse. A 2‐year‐old Thoroughbred colt was hospitalised 5 weeks after an episode of severe colic that was followed by gradual weight loss and anorexia, pyrexia for 5 days and dehydration on the day of referral. A large splenic abscess was identified ultrasonographically. Following initial medical treatment, an exploratory laparotomy was performed. Multiple adhesions were released and a partial splenectomy conducted to remove the abscess. Migrant metallic wires penetrating from the small intestine into the splenic parenchyma were found to be the cause for the adhesions and the abscess. This paper summarises the potential advantages of utilising a partial vs. a total splenectomy and highlights the potential complications of these surgical procedure in equines.

Splenic abscessation: Is partial splenectomy a treatment option?

“…The authors of the case report in this edition (Thomson et al . 2020) elected to use a ventral midline approach which is better suited to wider abdominal exploration (Dart and Bischofberger 2011) and is likely to have contributed to the successful outcome in this case.…”

“…Despite the author's concerns about risk of perforation and contamination of the peritoneal cavity or haemorrhage (Thomson et al . 2020), successful ultrasound‐guided aspiration of the mass or even retrieval of an abdominal fluid sample in the case presented in this edition may have provided a more complete picture to decide whether attempting medical management would have been a more suitable approach to treatment, at least initially, particularly in light of the poor success reported with surgical treatment.…”

“…The case presented by Thomson et al . (2020) in this edition of Equine Veterinary Education describes a 2‐year‐old Thoroughbred colt presenting with a splenic abscess secondary to migrating metal wires. This colt underwent a partial splenectomy and is the first reported case of successful surgical treatment of a splenic abscess (Rosso et al .…”

“…In the colt reported in this edition (Thomson et al . 2020), adhesions were limited to the body wall and adjacent intestine and were amenable to resection. The localisation of the infection and the ability to surgically access, manipulate and free the adhered intestinal segments without excessive contamination or haemorrhage were features of this case that facilitated the surgical process and outcome.…”

“…It is not entirely clear in the case report whether complete splenectomy was a treatment option (Thomson et al . 2020) but, in the absence of reports of overwhelming post‐splenectomy syndrome being a concern in the horse, a complete splenectomy may have been associated with less risk of haemorrhage and provided an alternative approach in this or future cases. Alternatively, other approaches to haemostasis such as large jaw thermal vessel sealers and haemostatic scaffolds alone, or in combination, along with other means of haemostasis could be considered in future cases.…”