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Canine

Acute oropharyngeal puncture wounds: a review

02 April 2022
Features
02 April 2022
Volume 27 · Issue 4
Figure 5. A lateral cervical radiograph demonstrating emphysema. Gas lucencies are seen subcutaneously (arrow 1) and within the fascial planes of the neck (arrow 2). Any gas lucency evident that is not within the trachea or oesophagus raises suspicion of dorsal pharyngeal or oesophageal puncture.
Figure 5. A lateral cervical radiograph demonstrating emphysema. Gas lucencies are seen subcutaneously (arrow 1) and within the fascial planes of the neck (arrow 2). Any gas lucency evident that is not within the trachea or oesophagus raises suspicion of dorsal pharyngeal or oesophageal puncture.

Abstract

Oropharyngeal injuries are commonly seen in practice. Severity can range from minor to life threatening in the case of dorsal pharyngeal or oesophageal punctures. A prompt diagnosis and early aggressive surgical management may be required to prevent the development of mediastinitis and sepsis. This article will look at acute injuries and outline a systematic approach to these cases, enabling the clinician to make early decisions rather than adopting a ‘wait and see’ approach.

Acute oropharyngeal puncture wounds are relatively uncommon occurrences in general practice but are potentially life-threatening events if not recognised (Griffiths et al, 2000). In cats and dogs, they can be caused by a variety of foreign bodies such as wood, metal, bones, sewing needles and fish-hooks (White and Lane, 1988; Griffiths, et al, 2000). In dogs, the most common presentation is associated with carrying, chewing or retrieving wooden sticks (Hallstrom, 1970; White and Lane, 1988; Doran, et al, 2008; Anderson, 2017). More severe injuries often occur when an owner throws a stick that embeds in the ground and the dog runs onto the protruding end with an open mouth (Bray, 2019). Medium to large breeds of dog appear to be over-represented among dogs with puncture wounds caused by sticks, and a relationship between large breeds and low head carriage at the time of stick retrieval is believed to be a possible cause for these cases (White and Lane, 1988; Griffiths et al, 2000). While more commonly seen in dogs, a case of a wooden oropharyngeal foreign body has been reported in a Bengal cat (Bright et al, 2002).

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