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Surgical Management of Tracheal Rupture in a Goat.

Abstract

A male goat was presented with history of dog bite, bleeding and swelling at neck. Clinical examination revealed emphysema around the neck, dyspnoea with irregular respiration and air escaping from site of wound during expiration. Fluoroscopy revealed tracheal injury with peritracheal air infiltration. Tracheal rings were anastomosed in dorsal recumbency and animal recovered uneventfully on 10th post-operative day.

Keywords: Dog bite; dyspnoea; emphysema; tracheal injury

Introduction

The trachea in caprines is a 'U' shaped cartilaginous and membranous tube that extend caudally from larynx, at level of 2nd cervical vertebra to 3rd thoracic vertebra (Nzalak et al., 2013), The trachea consists of 48-60 cartilages, to the insides of which trachealis muscle is attached (Konig and Liebich, 2007). Laceration of trachea should be severe enough to produce significant subcutaneous and mediastinal emphysema. Extensive tissue damage frequently accompanies penetrating bite and gunshot wounds (Nelson, 2002). Gilson (1998) reported dyspnoea, subcutaneous emphysema, air transgression through the open wound and pneumomediastinum as the common findings of tracheal rupture and is treated as emergency. Tracheal anastomosis is indicated for management of benign and malignant tracheal stenosis, traumatic tracheal disruption and segmental tracheomalacia (Fingland, 1998). The article presents tracheal injury in a goat due to dog bite and its surgical management.

History and Diagnosis

A one year old male goat was presented with history of dog bite, bleeding and swelling at neck region. On physical examination, multiple bite wounds were evident at ventral neck region (Fig.1) and expiratory air was gushing out from one of the bite wounds and was audible. Animal was in dyspnoea with irregular respiration. Subcutaneous emphysema was evident around the bite wound. Bite wounds were also noticed in medial thigh region but are not deep enough to cause damage to underlying muscles. Fluoroscopy of neck revealed escape of air from damaged trachea during expiration and accumulation of air in subcutaneous tissue (Fig. 2) confirming tracheal injury and it was decided to perform reconstructive surgery.

Treatment

Animal was placed in dorsal recumbency, ventral neck was scrubbed and prepared aseptically. The goat was sedated using Xylazine hydrochloride (Xylaxin (a)) @ 0.03 mg/kg b. wt. and upon linear infiltration of 2 percent Lignocaine hydrochloride (Inj Xylocaine (a)) incision was made on bite wound. The paired sternocephalicus and sternohyoideus muscles were separated and trachea was exposed. Trachea was not damaged much, there was tear in annular ligament and mucosa of trachea ventrally (Fig.3) and tracheal rings were not damaged. The proximal and distal tracheal cartilages were sutured by using 2-0 polyamide suture material (Fig. 4) and ensured that there are no other perforations in trachea. Opposing sutures were such that bite was taken through tracheal cartilages. The sternohyoid and sternocephalicus muscles were opposed by simple continuous sutures by chromic catgut no.1 and subcutaneous tissues were closed in same manner. The skin was closed with cross mattress pattern by polyamide no 1-0 (Fig. 5). Post-operatively, Ceftriaxone (Intacef (b)) @ 15 mg/kg b. wt. was administered intramuscularly twice daily for 5 days, Meloxicam (Melonex (b)) @ 0.2mg/kg b. wt. intramuscularly once daily for 3 days, daily wound dressing and post bite rabies vaccine and tetanus toxoid were administered. The goat recovered uneventfully on 10th post-operative day.

Discussion

Dog bite wounds of neck are common and may result in injuries to trachea, larynx, esophagus, pharynx, associated blood vessels and nerves. Penetrating injury is more likely to result in airway laceration (Nelson, 2002). In xxxxxxxxxxpresent case, dog bite near the neck resulted in tracheal injury. Dyspnoea, subcutaneous emphysema, air transgression through the open wound and pneumomediastinum are the common findings of tracheal rupture (Gilson 1998). Where as in present case, expiratory air was gushing out from one of the bite wounds, dyspnoea with irregular respiration and subcutaneous emphysema was evident around neck. Tracheal fractures produce radiographic signs of peritracheal, intramuscular and subcutaneous emphysema (Etinger and Ticer, 1983), similar signs were observed in this case also.

In the present case, simple interrupted suture pattern was employed using 2-0 polyamide non absorbable suture for closure of tracheal wound. The procedures were in accordance with Dar et al. (2011). Tracheal rupture due to dog bite and its surgical management in a Pomeranian dog by Tiwari et al. (2011) and in goat by Dar et al. (2011) were reported. In the present paper successful surgical management of tracheal injury in a goat due to dog bite is reported.

References

Dar S.H., Makdhoomi, D.M. and Fazili, M.R. (2011). Tracheal Injury due to Dog bite and its Surgical management in a Goat. Intas Polivet 12: 193-94.

Etinger, S.J. and Ticer, J.W. (1983). Disease of trachea in ettinger SJ (Ed) Veterinary Internal Medicine, 2nd ed.WS Saunders, Philadelphia, p. 723.

Fingland, R.B. (1998). Tracheal resection and anastomosis, In:Current Techniques in Small Animal Surgery, (ed) M.J. Bojrab, 4th Edn., Williams and Wilkins, Pennsylvania, USA, p. 387.

Gilson Stephen, D. (1998). Self Assessment Colour Review of Small Animal Soft Tissue Surgery, 1st Edn., Manson Publising Limited, London, p. 102-13.

Konig, H.E. and Liebich, H.G. (2007). Respiratory system of Veterinary Anatomy of Domestic Mammals -Textbook and Colour Atlas. 3rd edn. p. 382-83.

Nelson, A.W. (2002). Disease of the trachea and bronchi. In: Text Book of Small Animal Surgery, 3rd edn., Douglas Slatter (Ed), p. 858-80.

Nzalak, J. O., Ibe, C. S., Salami, S. O., Umosen, A. D., Ali, M. N., Byanet, O., Maidawa, S. M and Imam, J. (2013) Macroscopic Studies of the Lower Respiratory System of the Red Sokoto Goat (Capra aegagrus hircus). J. Vet. Anat. 6: 47-52.

Tiwari, S.K., Deepak Kumar Kashyap and Sharda, R. (2011).Tracheal Rupture due to Dog bite and its Surgical management in a Pomeranian dog. Intas Polivet 12:195-96.

D.R. Manjunatha (1), Basavaraj Balappanavar (2) and H.M. Rakshith (3)

Department of Veterinary Surgery and Radiology Veterinary College Karnataka Veterinary, Animal and Fisheries Sciences University (KVAFSU) Vidyanagara Hassan - 573202 (Karnataka)

(1.) Assistant Professor, Department of TVCC and Corresponding author. E-mail: manjuvet328 @gmail.com

(2.) Assistant Professor

(3.) Post Graduate Scholar

(a) - Brand of Indian Imunological Ltd., Hyderabad

(b) - Brand of Intas Animal Health, Ahmedabad
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Article Details
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Title Annotation:Short Communication
Author:Manjunatha, D.R.; Balappanavar, Basavaraj; Rakshith, H.M.
Publication:Intas Polivet
Article Type:Report
Date:Jul 1, 2016
Words:1019
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