Postoperative management following traumatic evisceration in a 6 year old Morgan mare
A 6 year old Morgan mare presented with a one hour history of having sustained a traumatic evisceration after falling onto a farrier’s stand. The owner suspended the abdominal contents within a bed-sheet sling; viscera had not touched the ground. On presentation the patient was severely painful. She was sedated and treated with hypertonic saline followed by isotonic fluids. The sling was reinforced with elastikon prior to induction for surgery. Following induction the eviscerated intestine was lavaged and replaced into the abdomen, and the wound was temporarily closed. A jejuno-jejunostomy was performed through a midline celiotomy, and an indwelling abdominal drain was placed. The traumatic wound was re-explored and closed after placement of a Penrose drain. Anticipated postoperative complications included incisional infection, peritonitis, intra-abdominal adhesions, endotoxemia, laminitis, and postoperative ileus. Treatments addressing these complications included intraoperative use of 1% carboxymethylcellulose, peritoneal lavage, heparin, broad-spectrum antibiotics, hyperimmune plasma, polymyxin B, cryotherapy, flunixin meglumine, and lidocaine. The patient recovered well.
Senior seminar paperSeminar SF610.1 2014
Horses -- Wounds and injuries -- Case studies; Horses -- Surgery -- Case studies