Case of the Month

Unusual haematoma due to accident in a buffalo

Drs. Prem Singh, Sandeep saharan, Rishi Tayal  S.M. Behl and R.K. Chandolia

LLRUVAS, Hisar-125004 (Haryana)

 

  Formation of haematoma in not so common in buffaloes. Any swelling on the body of the animal can be suspected for any abscess, tumour, cyst or hernia but swelling due to haematoma formation is a rare phenomenon.  It can occur due to rupture of blood vessel following any trauma. If there is rupture of major blood vessel than swelling so formed will be big in size. It is usually superficial vein/ veins which get ruptured. In this particular buffalo, haematoma formation is due to falling of a small portion of wall over the back of the buffalo resulting in appearance of big swelling over the back of the buffalo. Formation of haematoma is reported in dairy cattle toward ventral side of neck and mid ventral portion of the thigh (Braun et. al., 2007; Ali et. al., 2012) but it is not on the record in buffaloes. The case was differentiated from abscess, tumour, cyst or hernia on the basis of test puncture and ultrasonography. The diagnosis was confirmed later on the basis of surgical findings.

Case history & systemic examination

The buffalo was attended at university animal farm. Swelling over the back of buffalo went unnoticed over a long period because the animal was kept in dry herd. When it came to the notice of animal attendant by that time it assumed a big size. When inquired how the swelling appeared than attendant replied that some buffaloes were sitting near a old boundary of the animal shed and a portion of it got fell down over that particular buffalo but at the time of falling of the wall there was not any clue of the swelling and the buffalo stood up without any difficulty and went to the manger for feeding but after a gap of twenty days he noticed big swelling over the back of the buffalo and reported the matter to the veterinary officer. When the buffalo was attended by clinical staff there was big swelling over the back of the buffalo (fig.-1).

(Fig.-1 showing gross appearance of swelling at the back of buffalo)

The buffalo was alert and taking feed and water normally. The rectal temperature, heart rate and respiratory rate were normal. The mucous membranes were also normal. There was no affect of the swelling over the spinal cord. The movement of the limb and tail was normal. The defecation and urination was also normal. The ultrasonographic images were taken at different part of the swelling. In outer portion of the swelling the ultrasonographic image was different and in the middle portion of the swelling the ultrasonographic picture was entirely different (fig.2 &3).

                                      

    (Fig.-2 USG of periphery of haematoma)                           (Fig.-3 USG of middle of haematoma)

The ultrasonographic image toward periphery of the haematoma was anechoic indicating presence of fluid i.e. serum toward periphery of the haematoma and in the middle portion of the haematoma multiple lobules like structures were present with hyperechoic septa and anechoic shadow of the lumen of the lobule indicating presence of the blood clots and in between accumulation of fluid or serum in blood clots.

 

Surgical management

The buffalo was controlled in standing position in travis and sedated with xylazine 0.1 mg/kg by intramuscular route. The area of the swelling was prepared for aseptic surgery. When the swelling was opened, there was oozing of reddish serum from the periphery and there was accumulation of large number of blood clots in the middle of the swelling. These blood clots were also removed. Around 5 kg material was drained off from the swelling. After drainage of the swelling, the cavity of the swelling was packed with bandages soaked in local haemostat i.e. tincture benzoin co-A. The opening of the swelling was kept open for drainage. After three days of surgery, the dressing was started with Bismith  Iodoform Paste i.e. (B.I.P.P). Post drainage treatment include administration of dextrose saline 5% (1littre x 5) for 3 days, ceftriaxone (3.0 gms) for 5 days,  meloxicam (20ml) for 3 days, ethamsylate (10 ml) for 3 days, mecobalamine, vitamin-C & B-complex (20 ml) for 5 days and daily antiseptic dressing of the swelling with B.I.P.P. for 30 days. The swelling subsided completly after one month of B.I.P.P dressing (fig.-4).

                                                                              

(Fig.-4 showing complete subsidation of the swelling)

Discussion

 Any swelling due to injury over or near the vertebral column can cause pressure over the spinal cord thereby causing difficulity in getting up or down, passing of faeces and urine but in this particular case there were not such problems due to swelling. Ultrasonography was observed to be good imaging technique to differentiate and diagnose the swelling as haematoma. The blood clots from the haematoma were evacuated by surgical intervention. The bleeding in the cavity of haematoma after evacuation was controlled by local dressing of tincture benzoin-co A. The cavity of the swelling was locally dressed with B.I.P.P. and the dead space of the cavity gets obliterated in one month following dressing with B.I.P.P. Such type of successful treatment of haematoma is also reported by Braun et. al., 2007  in cattle. 

                                                                                     References

Braun, U., Hauser,B., Meyer,S. and Feller,B. 2007. Cattle with thymic lymphoma and haematoma of ventral neck: a comparison of findings. Vet J.174(2):344-50.

Megda, M. Ali, Abd El-Hakiem. 2012. Ultrasonographic Differential diagnosis of superficial swelling in farm animals. Journal of Advanced Veterinary Research. 2: 292-298.

 

     

 
 

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