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Case Reports
. 2023 Nov;13(11):1471-1477.
doi: 10.5455/OVJ.2023.v13.i11.11. Epub 2023 Nov 30.

Management of uroperitoneum through combination of conservative and surgical treatments in two colts

Chiara Montano  1 , Giulia Forni  2 , Aliai Lanci  2 , Jole Mariella  2 , Chiara Del Prete  1 , Mariaelena de Chiara  1 , Maria Pia Pasolini  1 , Riccardo Rinnovati  2
Affiliations
Case Reports

Management of uroperitoneum through combination of conservative and surgical treatments in two colts

Chiara Montano et al. Open Vet J. 2023 Nov.

Abstract

Background: Ruptures of the urinary bladder and urachus are the most frequent cause of uroperitoneum in foals. Surgical correction is often the first treatment choice, however, nonsurgical methods, such as urine removal via urinary catheters and abdominal drains, have been successfully performed in foals.

Case description: Two foals were referred to the Equine Perinatology Unit for suspicion of uroperitoneum. The diagnosis was confirmed by hematobiochemical and ultrasound examinations, thus cystorrhaphy and cystoplasty were attempted. Surgeons found a lesion in the dorsocranial margin of the bladder (Case 1) and a tear in the pelvic urethra (Case 2); in the first case, the defect was routinely repaired, while the last lesion was impossible to repair due to its localization. A urinary catheter was left in place in both cases. Uroperitoneum recurred 72 hours after the surgery in both foals: a second surgical correction was not recommended due to the localization of the tears and conservative treatment, with the placement of a 32F chest tube in the most ventral part of the abdomen, was preferred. Abdominal drains were removed 5-7 days after surgery, while urinary catheters were left in place for up to 7-8 days. Colts' conditions improved during hospitalizations. Two months after bladder surgery, Case 1 was euthanized due to multiple adhesions between the small intestine and the abdominal wall. Case 2 was still alive one year postoperatively.

Conclusion: Although it cannot be considered the first choice for the treatment of uroperitoneum in the foal, nonsurgical treatment was successful in both cases in the short-term follow-up. However, the prognosis should be cautious due to the risk of long-term complications. Conservative management may be used to manage bladder/urethral tears that cannot be solved by surgery.

Keywords: Abdominal drainage; Cystoplasty; Cystorrhaphy; Foal; Urinary catheter.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1.
Fig. 1.. Bladder rupture in the dorsocranial portion of the urinary bladder in Case 1. Black arrow: bladder tear.
Fig. 2.
Fig. 2.. Intraoperative images of Case 1: adhesions between segments of small intestine.
Fig. 3.
Fig. 3.. Abdominal drain in Case 2.
See this image and copyright information in PMC

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