VSR 421: Regional Veterinary Surgery (2+1)

TRAUMATIC RETICULO PERICARDITIS

Synonym - Hardware Disease 

Etiology

• Perforation of the pericardium by the foreign body present in the reticulum
• Two main reasons attributed to this condition are
• Cattle do not discriminate metallic and non metallic objects while ingestion
• Cattle do not masticate before swallowing

Pathophysiology

• In a normal functioning heart the right side pressure is less than the left side during diastole
• When fluid accumulated in between heart and pericardium due to penetrating foreign body this pressure equilazes and results in Cardiac Tamponade
• Later penetration into myocardium results in death

Clinical Signs

• Brisket edema
• High Temperature 104 F
• Pleuritis may manifest as shallow respiration muffled heart sounds (washing machine murmur) and pleuritic friction rubs
• Jugular vein distension and Jugular pulse

Diagnosis

• Clinical signs
• Neutrophilia and left shift in blood picture
• Radiography
• Ultrasonography

Treatment

• Reducing the intrapericardial pressure is the primary goal.
• Fifth rib resection and pericardiocentesis using a IV tube in slow manner is attempted as sudden releiving of pressure leads to cardiac arrest.
• Removal of the foreign body if encountered is done.
• Pericariectomy is done as salvage procedure in severely affected cases.
• Marsupialization (attaching the pericardial sac to skin wound) can also be attempted.
• Surgical drain is a mandatory procedure.
• High end antibiotics like tetracyclines are indicated following surgery
• Lavage of pericardium is done before closure.
• Supportive therapy in form of diuretics, inotrpic agents like digoxin and fluid therapy is necessary following surgery.