Tracheal Stenosis in a Blue-Billed Currasow (Crax alberti)

Abstract

A blue-billed curassow (Crax alberti) was anesthetized for a preshipment physical exam. Sixteen days later, the curassow presented with acute onset of dyspnea and respiratory stridor. The bird was stabilized by placement of an air sac canula. Tracheal stenosis was diagnosed with radiographs. It was suspected that the tracheal stenosis was due to trauma from a previous endotracheal tube placement. A tracheal resection and anastomosis was performed. Three days postoperatively the air sac canula was removed. Although there were increased respiratory sounds, the trachea had not completely restrictured. Ten months later, the currasow presented for dyspnea and died shortly thereafter. There was mycotic airsacculitis with Aspergillus organisms present. Tracheal stenosis in birds after tracheal intubation is a frequently discussed condition with very little published material available. This report describes a case of tracheal stenosis postintubation and the surgical treatment and subsequent complications that followed.

Review of 23 Cases of Postintubation Tracheal Obstructions in Birds

“…13 Possibly the rate of this narrowing is more acute in susceptible species, causing their tracheas to be more easily traumatized by the end of an endotracheal tube that passed easily through the glottis but contacts and presses on the tracheal wall proximally. One indication from the data supporting this theory is that at least one surgical report in this series (bird 5), in addition to reports in the literature, 4,7,12 noted an unequal diameter of the trachea on either end of the resection site. This possible species predisposition might also explain the relative lack of cases reported in the literature, compared with the complication rate observed at these institutions.…”

“…Most of the literature involving tracheal obstructions in birds from multiple causes report surgical solutions, [2][3][4]7,[10][11][12]14,15,17,19 with only a few reporting successful nonsurgical interventions. 14, 23,24 In this report, attempts at tracheotomy for debulking of the obstruction were unsuccessful and resulted either in death or subsequent resection and anastamosis (RA).…”

“…28 The literature in avian cases of tracheal obstruction, regardless of cause, reports occlusion of between 50% to 90% at the time of diagnosis, consistent with findings in this report. 2,4,5,7,10,15 It is reasonable to conclude that birds affected to a lesser degree (i.e., ,50% occlusion) could be subclinical and remain undiagnosed. If this is the case, the complication rates found in this report might underestimate the problem.…”

“…6 However, the rate of this complication appears to be low as only a few reports are available in the literature. 4,7,12,14,19,23 This complication is life-threatening and often requires surgical correction, which is not always successful. 4,7,14,19 No published studies have attempted to determine the etiology, predisposing factors, or relative rate of this complication in avian practice.…”

Galliformes and Columbiformes

“…Some clinicians prefer not to intubate these species because of the potential for tracheal obstruction or stenosis postoperatively (Evans et al 2009). This, unfortunately, precludes supportive ventilation.…”