Oesophageal muscular hypertrophy and pulsion diverticulum in a Friesian horse

A 13-year-old Friesian stallion was referred for evaluation of acute coughing and bilateral nasal discharge. Thoracic radiographs revealed dilation of the terminal portion of the oesophagus, forming a thin-walled outpouching containing soft tissue opaque material and gas. A diagnosis of oesophageal obstruction with an impacted diverticulum was made. Caudal oesophageal muscularis hypertrophy and an impacted oesophageal diverticulum were found on postmortem examination. Histological abnormalities included a thick caudal oesophageal tunica muscularis and an oesophageal diverticulum composed of mucosa, submucosa and adventitia. Muscular hypertrophy of the oesophagus with diverticulum formation should be considered in Friesian horses presenting with clinical signs of oesophageal obstruction. In this case, thoracic radiographs contributed to a premortem diagnosis, guided medical management and provided information on prognosis. Thoracic radiography can be used as a complementary test in the diagnosis of oesophageal obstruction when endoscopy is available and is a useful diagnostic alternative when endoscopy is not an option.

Large mediastinal haematoma after paraoesophageal hernia repair

Mediastinal haematoma is a rare complication of laparoscopic paraoesophageal hernia repair with few documented cases in the current literature. Presentation of this unique clinical problem can range from extrinsic oesophageal obstruction to life-hreatening cardiac tamponade and therefore, warrants further discussion of at-risk population aetiology, diagnosis and successful management strategies. We present the case of a 71-year-old woman who underwent laparoscopic paraoesophageal hernia repair with nissen fundoplication complicated by severe dysphagia on postoperative day 12. Further evaluation with oesophagram and CT imaging revealed a large mediastinal haematoma with near obstruction of the distal oesophagus. This was managed successfully with laparoscopic transhiatal washout and drainage.

Swing-back and trap-door technique repair for interrupted aortic arch with right-sided descending aorta

A right-sided descending aorta with a left aortic arch is a rare congenital anomaly in which the aortic arch crosses the midline from the left side of the trachea coursing to the descending aorta in the right thoracic cavity. The surgical repair of an interrupted aortic arch with a right-sided descending aorta carries great risks of bronchial and oesophageal obstruction. Herein, we describe a case of successful surgical repair of an interrupted aortic arch with a right-sided descending aorta using the swing-back and trap-door techniques.