Trans-luminal adhesions
Keywords: foaling, injury, obstetrics, adhesionsPurulent discharge seen on the floor (red ellipse) behind a mare. This mare discharged pus intermittently because of multiple draining abscesses that had formed in her vagina. These abscesses formed between trans-luminal adhesions caused by vaginal irritation. This followed prolonged intervention during dystocia. This also caused obliteration of the cervix.
Image size: 2240 x 1606px
This illustration also shows how the extent of trans-luminal adhesions can be evaluated using transrectal ultrasonography and an infusion of saline. At the upper right corner, a green check mark shows the normal appearance of saline in a uterine lumen. Its echogenicity is due to microscopic bubbles of air that are normally found in saline. This appearance makes saline an ideal contrast medium for the evaluation of the uterine and vaginal integrity using ultrasound.
In the red rectangle, one can see how poorly an infusion of saline had distributed itself within the uterine lumen of another mare. That mare had severe trans-luminal adhesions throughout her uterus, probably as a result of a foaling injury.
Trans-luminal vaginal adhesions arising from the management of dystocia are not uncommon. To prevent trans-luminal adhesions from forming, a lubricating substance such as oil-based mastitis ointment can be applied to the vaginal wall two or three times at 48 hrs intervals after relieving an equine dystocias. Similar adhesions are rare in other species following treatment for dystocia; the equine vaginal wall appears to be especially sensitive to abrasion and chemical irritation.
