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.
