Bronchial foreign body

 

This filly was admitted in a February for endoscopic removal of a foreign body from the trachea which had been identified by another vet. The filly had previously lacerated her tongue on a rat chain and monitoring of this laceration had led to the observation that the filly had a foul smelling breath. The filly was subsequently endoscoped and a foreign body identified.

 

Under sedation a portion of a twig was seen to be embedded in the wall of the right mainstem bronchus and was surrounded by an amount of purulent discharge. In a slightly laborious procedure taking two hours the twig was finally snared using a transendoscopic loop and was removed from the trachea. The filly was continued on anti-inflammatories and antibiotics. A subsequent endoscopy the following morning showed no evidence of a residual foreign body and the filly was discharged.

 

 

 

Fast forward four months….

She was re-admitted in June for endoscopic removal of a foreign body from the trachea I had identified during a tracheal wash. It was quite by chance that I was even at this trainer’s yard but no one else was available. The head lad reminded me that we had taken a twig out previously so I thought we should have a look again. She had been training well but coughed occasionally and still had foul smelling breath.

 

Endoscopy on the day of admission revealed another portion of a twig at a similar location within the right mainstem bronchus but it’s length could not be ascertained from the end-on view (See the video). The twig was snared using a transendoscopic loop and successful removal revealed a 1cm x 23cm long stick with intermittent barbs and thorns down its length. Extraction of the twig required a fair amount of traction to free it from the wall of the bronchus and produced a prolonged epistaxis (actually, the mother of all nosebleeds) from the thorns causing the loss of approximately 15 litres of blood. The filly was supplemented with intravenous fluids and monitored intensively due to the severity of blood loss but seemed remarkably unperturbed by the whole procedure and went home the next day.

 

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