A five year old Jersey cow was presented with a history of inability to swallow feed and water, excessive salivation, restlessness, regurgitation of feed and water through nostrils, severe bloat and palpable swelling at the left lateral cervical part of the oesophagus. It was diagnosed as a cervical oesophageal obstruction (choke) by passing stomach tube. Oesophagotomy was performed and foreign body (unripened mango) was successfully removed.
Esophageal obstructions in cattle commonly occur at the pharynx, the cranial aspect of the cervical esophagus, the thoracic inlet, or the base of the heart (Misk, 2004). In cattle, obstruction of the oesophagus (choke) prohibits the eructation of ruminal gases and develops severe free gas bloat which may be life threatening if not treated in time (Prakash et al., 2014). Many authors retrieved foreign objects like large feedstuff, vegetables, phytobezoars (Tyagi and Singh, 1999), pieces of leather or rubber (Salunke et al., 2003), coconut (Madhva Rao et al., 2009), palm kernels (Hari Krishna, 2011), medicated boluses, trichobezoars etc. in large animals. The present paper reports cervical oesophageal obstruction caused by unripened mango and its surgical management in a jersey cow.
Case History and Clinical Signs
A five year old Jersey cow was presented to the Department of Surgery and Radiology, College of Veterinary Science, Tirupati with a history of swelling at the ventral neck region, inability to swallow feed and water, excessive salivation, restlessness, regurgitation of feed and water through nostrils and severe bloat for one day. Owner suspect that animal might have consumed unripened mango. Trocharization was done by local veterinarian to relieve bloat but no improvement was noticed. On clinical examination, swelling was noticed at the left lateral aspect of the neck and it was palpated as a hard object. Physiological parameters like rectal temperature, respiratory rate and heart rate were within normal limits. An attempt was made to push the mass into rumen with the help of a stomach tube and was unsuccessful. Based on history and clinical signs it was diagnosed as cervical oesophageal obstruction and decided to perform oesophagotomy.
|Fig.1: Incision over the foreign body||Fig.2: Removed Foreign body (Unripened Mango)|
Treatment and Discussion
Animal was restrained in right lateral recumbency and surgical site was prepared aseptically. 2% lignocaine hydrochloride was infiltrated around the swelling to achieve local analgesia. A longitudinal incision was made along the superior border of the jugular furrow, close to the level of obstruction between sternocephalicus and trachea. Oesophagus was exposed and a longitudinal incision (Fig.1) was made directly over the foreign body (unripened mango) and the same was removed (Fig.2). The mucosal layer was sutured with simple interrupted sutures using chromic catgut No. 2/0. Sub mucosa and muscularis were opposed with simple continuous pattern using No. 2/0 chromic catgut. The muscles and skin were closed in routine manner. Post operatively, feed was withheld for 5 days and animal was maintained with Normal Saline and Ringers lactate each @ 15ml/kg body weight intravenously. Inj. Streptopenicillin 5gm and Inj Meloxicam @ 0.5mg/kg between were administered intramuscularly for 3 days. There were no post operative complications and animal made uneventful recovery on tenth post operative day.
In bovine practice, esophageal obstruction caused by foreign objects is considered one of the most important emergency surgical conditions which require immediate intervention, as blockade of the esophagus may cause severe bloat. Bovine are more frequently affected by esophageal obstruction than other animals, and this is attributable to their peculiar feeding habits (Smith, 2008). Ruben, (1997) reported the risk of post operative complications associated with an esophagotomy as incisional dehiscence and fistula formation but in present case, no such complications were seen. In the present study, cervical choke caused by unripened mango fruit and its successful surgical management was reported.