Topic:Adhesions
Effect of carboxymethylcellulose and hyaluronate solutions on jejunal healing in horses. To compare a double-layer inverting anastomosis with a single-layer appositional anastomosis, coated with either 1% sodium carboxymethylcellulose (SCMC) or 0.4% sodium hyaluronate (HA) solutions, in the small intestine of horses with respect to anastomotic healing and adhesion formation. Methods: 18 adult horses. Methods: Midline celiotomy and end-to-end jejunal anastomoses were performed. In control group horses (n = 6), a double-layer inverting anastomosis coated with sterile lactated Ringer's solution was performed. In treatment group horses, a single-layer appositional anastomosis was perf...
In situ coagulation and transection of the ovarian pedicle: an alternative to laparoscopic ovariectomy in juvenile horses. The feasibility of leaving the ovaries within the peritoneal cavity after laparoscopic coagulation and transection of the ovarian pedicle was assessed in the juvenile horse. Elective ovariectomy was performed on 10 quarter horses, aged 4 to 5 mo, with the fillies in a Trendelenburg position. The mesovarium was isolated, and multiple coagulation and transection cycles were performed until all ovarian attachments had been severed. The ovaries were dropped within the abdomen, and hemostasis of the transected mesovarium was evaluated before closure. The mean surgical time was 33 min (range, 23 to ...
Prevention and treatment of gastrointestinal adhesions. As with many aspects of clinical medicine, there is yet to be a single or definitive cure for postoperative adhesion formation. Current methods of prevention target risk factors predisposing horses to adhesion formation. Systemic pharmacologic therapies, such as antimicrobials, nonsteroidal anti-inflammatory drugs, Salmonella antiserum, and hyperimmune plasma, help to reduce abdominal inflammation and minimize the effects of endotoxemia. Intra-abdominal or systemic heparin aids in enhancing peritoneal fibrinolysis. Prokinetic therapy promotes early postoperative return of intestinal motility, ...
Evaluation of Carolina Rinse solution as a treatment for ischaemia reperfusion of the equine jejunum. Ileus and peritoneal adhesions are the most common complications following surgery for small intestinal obstruction. Carolina Rinse (CR) has been shown to decrease reperfusion injury in intestine and other organs. Objective: CR decreases intestinal inflammation and subsequent scarring associated with reperfusion injury. Methods: CR was infused intra-arterially and applied topically just prior to reperfusion in jejunum exposed to experimental ischemia. Vascular permeability, neutrophil accumulation and serosal scarring were compared in treated and untreated intestine. Results: CR maintained a n...
Healing characteristics of deep digital flexor tenorrhaphy within the digital sheath of horses. To describe the healing characteristics of deep digital flexor tenorrhaphy within the digital sheath. Methods: Experimental study. Methods: Five mature horses. Methods: Right thoracic limb, deep digital flexor tenorrhaphy was performed within the digital sheath. Limbs were cast in partial flexion using a short limb cast for 6 weeks. Next, extended heel shoes were used for limb support for 14 weeks. Healing was evaluated by sequential ultrasonographic examinations, and limb use was evaluated by force plate analysis. At 26 weeks, mechanical strength and morphologic characteristics of the repair ...
Use of an active intra-abdominal drain in 67 horses. To describe the insertion technique, efficacy, and complications associated with the use of an active (closed-suction) abdominal drain in horses. Methods: Retrospective study. Animals-Sixty-seven horses with abdominal contamination treated by abdominal lavage and use of a closed-suction abdominal drain. Methods: Medical records of horses (1989-1996) that had a closed-suction abdominal drain were reviewed. Follow-up information was obtained by telephone interviews with owners. Results: Sixty-eight closed-suction abdominal drains were used in 67 horses that had abdominal contamination, peritonit...
Use of a high-molecular-weight carboxymethylcellulose in a tissue protective solution for prevention of postoperative abdominal adhesions in ponies. To evaluate efficacy and safety of IP administration of high-molecular-weight carboxymethylcellulose (HMW CMC) for the prevention of postoperative intra-abdominal adhesions in ponies. Methods: 10 ponies. Methods: A 1% solution of HMW CMC was instilled intra-abdominally prior to surgery in 5 ponies, whereas 5 control ponies did not receive HMW CMC. Postoperative adhesions were induced by use of a bowel-abrasion method comprising laparotomy, typhlotomy, and abrasion of jejunal serosa at multiple sites with placement of 3 sutures at each site. Day of surgery was day 0. After surgery, ponies were ...
Equid herpesvirus 1 infection of endothelial cells requires activation of putative adhesion molecules: an in vitro model. Antisera to activated equine endothelial cells, which detected surface molecules of 116 kD, 97 kD, 42 kD and 38 kD, were made to investigate the role of endothelial adhesion molecules in equid herpes virus 1 infection. These putative adhesion molecules could be induced by 17-beta oestradiol, chorionic gonadotrophin, or IL-2, as well as by LPS and PWM. In an in vitro flow system, using equine veins or arteries, equid herpesvirus 1 in leucocytes was only transferred to infect endothelial cells if both leucocytes and endothelial cells expressed these surface molecules. Blocking of the membrane mo...
Evaluation of laparoscopic adhesiolysis for the treatment of experimentally induced adhesions in pony foals. To assess the efficacy of laparoscopic adhesiolysis in the treatment of experimentally induced adhesions in foals. Methods: 8 healthy pony foals. Methods: Celiotomy was performed and adhesions created at the jejunoileal junction and at sites 0.5 and 1 m proximal to this junction, using a serosal abrasion method. Ten days after celiotomy, exploratory laparoscopy was performed. Laparoscopic adhesiolysis was performed in the treatment group only (4 foals, randomly selected). Thirty days after the exploratory laparoscopy, a final laparoscopic examination was performed, and the foals were euthanati...
Clinical signs and treatment of chronic uterine torsion in two mares. Two mares were evaluated because of chronic uterine torsions of 2 and 4 weeks' duration; both were pyrectic, anemic, tachycardic, and anorectic, had signs of depression, and had an abnormal uterus and contents on transrectal examination. Both mares underwent cesarean section for lysis of adhesions from the uterus to the peritoneum, correction of the torsion, and ovariohysterectomy Both mares recovered with only minor complications and returned to be used as riding horses. Chronic uterine torsion should be considered in mares in late stages of gestation that have vague clinical signs and transr...
Use of a hyaluronate membrane for jejunal anastomosis in horses. To compare the outcomes of double-layer inverting anastomosis (DIA), single-layer anastomosis (SLA), and single-layer anastomosis combined with a hyaluronate membrane (SLA+HA-membrane) with respect to stomal diameter, adhesion formation, surgery time, and anastomotic healing in horses. Methods: 18 adult horses. Methods: Midline celiotomy and end-to-end anastomoses were performed. In control horses (n = 6), DIA was performed; in treated horses, SLA was performed (6) or SLA+HA-membrane was performed (6). Horses were euthanatized 21 days after surgery. Abdominal adhesions were evaluated grossly a...
One percent sodium carboxymethylcellulose prevents experimentally induced abdominal adhesions in horses. To evaluate the efficacy of 1% sodium carboxymethylcellulose (SCMC) for prevention of experimentally induced abdominal adhesions in horses. Methods: Prospective, controlled, experimental study. Methods: Twelve healthy adult horses. Methods: The effect of 1% SCMC on adhesion formation was evaluated in 12 healthy horses by using an established model of serosal trauma to induce intraabdominal adhesions. After ventral median celiotomy, 2 separate areas of the jejunum were abraded, and three 2-0 chromic gut sutures were placed in each abraded area. Jejunal resection and end-to-end anastomosis was p...
Adherence of eosinophils from allergic and normal ponies to cultured equine endothelial cells. To compare adherence of stimulated and unstimulated eosinophils from allergic and normal ponies to cultured equine vascular endothelial cells (equine digital vein endothelial cells; EDVEC) and examine the effect of eosinophil-derived factor(s) on cell adherence. Methods: Eosinophil adherence to unstimulated EDVEC or EDVEC pretreated with IL-1beta or supernatants from stimulated eosinophils was measured. Supernatants were also assayed for TNFalpha and IL-1beta-like bioactivity. Results: Adherence of unstimulated and rhIL-5 (10 ng/ml)-stimulated eosinophils from allergic ponies to rhIL-1beta-tre...
Standing laparoscopic herniorrhaphy in stallions using cylindrical polypropylene mesh prosthesis. Standing laparoscopic herniorrhaphy was performed in 9 stallions. Appropriate analgesia was achieved by sedation with detomidine and local flank infiltration with mepivacaine. Three portal sites at the paralumbar fossa were used to perform the herniorrhaphy by means of triangulation. A cylindrical polypropylene mesh was inserted and fixated in the inguinal canal. Subsequent adhesion formation resulted in an obliterated inguinal canal within 2 weeks. This minimal invasive technique allowed us to perform a testis sparing herniorrhaphy in the standing horse.
Short- and long-term survival and prevalence of postoperative ileus after small intestinal surgery in the horse. The records of 74 horses that recovered from anaesthesia after surgery for a small intestinal lesion from 1994 to 1999 were reviewed. Sixty-three horses (85%) had a strangulating lesion and 43 of these (68%) had a resection and anastomosis. Four of 11 horses (36%) without a strangulating lesion had a resection and anastomosis. Sixty-three horses (85%) survived to discharge, with a survival rate of 53/63 in horses with a strangulating lesion (84%) and 10/11 (91%) in others. For all lesions, short-term survival for all end-to-end anastomoses (91%; 21/23) and for no resection (92%; 23/25) were su...
Effects of intraluminal distention and decompression on microvascular permeability and hemodynamics of the equine jejunum. To determine whether intraluminal distention and subsequent decompression of the equine jejunum affects intestinal blood flow, hemodynamics, and microvascular permeability. Methods: 5 healthy adu t horses. Methods: Horses were anesthestized and underwent exploratory laparotomy. Two jejunal segments were identified as sham-operated or instrumented segments. After baseline values were obtained, intraluminal distention was created in the experimental segment to induce an ntraluminal pressure of 18 cm H2O. After 120 minutes of distention, the intestine was decompressed for 120 minutes. Mesenteric ...
Colic surgery in 206 juvenile thoroughbreds: survival and racing results. The purpose of our study was to determine the types of lesions that cause colic in juvenile Thoroughbreds, factors associated with these lesions and the subsequent survival and athletic performance of the juveniles. The age of juvenile Thoroughbreds requiring surgical exploration for abdominal pain has an influence on the type of lesion causing colic. The short-term survival rate (discharge from the hospital) after colic surgery for foals was 85% and was strongly influenced by the lesion causing colic. Thirteen percent of juveniles recovered from the first surgery experienced another severe co...
Effect of carboxymethylcellulose and a hyaluronate-carboxymethylcellulose membrane on healing of intestinal anastomoses in horses. To evaluate the effect of sodium carboxymethylcellulose (SCMC) or a hyaluronate-carboxymethylcellulose membrane (HA membrane) on healing of the small intestine in horses. Methods: 18 healthy adult horses. Methods: Midline celiotomy and 2 jejunal resection-and-anastomosis surgeries were performed. In treated horses, SCMC (n = 6) or a HA membrane (6) was applied to the jejunum to cover the anastomosis. There were 6 untreated control horses. Horses were euthanatized 10 days after surgery. For each horse, 1 anastomosis was used for histologic examination, and the second was used to determine intes...
Evaluation of a bioresorbable hyaluronate-carboxymethylcellulose membrane for prevention of experimentally induced abdominal adhesions in horses. To evaluate the efficacy of a bioresorbable hyaluronate-carboxymethylcellulose membrane (HA-membrane) for prevention of experimentally induced abdominal adhesions in horses. Methods: Experimental study. Methods: Twelve healthy adult horses. Methods: The effect of an HA-membrane on adhesion formation was evaluated in 12 healthy horses using an established model of serosal trauma to induce adhesions. A ventral median celiotomy and two jejunal resections and end-to-end anastomoses were performed. Two separate jejunal areas were abraded, and three 2-0 chromic gut sutures placed in the abraded area...
Tenoscopic examination and proximal annular ligament desmotomy for treatment of equine “complex” digital sheath tenosynovitis. To determine the outcome of horses with "complex" digital tenosynovitis treated by tenoscopic proximal annular ligament desmotomy and resection of synovial masses or adhesions, or both, within the digital sheath. Methods: Retrospective evaluation. Methods: Twenty-five horses with a clinical and ultrasonographic diagnosis of palmar or plantar proximal annular ligament constriction and ultrasonographic evidence of synovial masses or adhesions within the digital tendon sheath. Methods: Each horse had tenoscopic surgery for annular ligament desmotomy combined with adhesiolysis and/or synovial mass...
Lameness associated with the bicipital bursa in an Arab stallion. Severe, chronic lameness in the left forelimb of a five-year-old Arab stallion was localised to the bicipital bursa by local anaesthesia and gamma scintigraphy. Radiographic and ultrasonographic examinations of the proximal humeral tubercles and bicipital bursa revealed new bone production in the region of the intertubercular grooves and irregularities in the density of the soft tissues of the bicipital tendon and bursa. An endoscopic examination of the bicipital bursa with a standard arthroscope under general anaesthesia was a useful diagnostic procedure. The stallion was euthanased, and mark...
Chyloperitoneum and abdominal adhesions in a miniature horse. Chyloperitoneum is a potential cause of colic in horses. Although rare in horses, chyloperitoneum can develop secondary to tearing of mesenteric adhesions and rupture of mesenteric lymphatic vessels. The prognosis for horses with chyloperitoneum depends on the underlying cause and the response to treatment.
Endoscopic examination of the tarsal sheath of the lateral digital flexor tendon in horses. This study was designed to develop a reliable technique for endoscopic examination of the tarsal sheath of the lateral digital flexor tendon of horses. The anatomy of the tendon sheath and associated structures was studied in detail in cadavers before determining portals for the insertion of an arthroscope into the sheath. Approaches into the sheath through the proximal pouch and through the flexor retinaculum, at the level of the sustentaculum tali, were performed and compared in cadavers. The proximal pouch portal permitted visualisation only of the proximal half of the sheath, while the app...
Ultrasound as an aid for diagnosis of ovarian abscesses in two mares. This report describes two mares presented for evaluation of anorexia, fever of unknown origin, and weight loss. Clinical examination, laboratory findings, and transrectal ultrasonographic images suggested ovarian abscessation. One mare was successfully treated medically. Because of financial considerations, the second mare was euthanatized and a postmortem examination was performed. At necropsy, there was an enlarged right ovary with an adhesion to the large colon. Microscopic findings were characteristic of an ovarian abscess.
Use of laparoscopic equipment to divide abdominal adhesions in a filly. Exploratory laparoscopy of the right dorsal portion of the abdominal cavity was performed on a Standardbred filly because of signs of mild abdominal pain of 7 days' duration. On the basis of clinical examination, diagnosis was suppurative peritonitis, abdominal adhesions in the area of the right ovary, and right displacement and impaction of the pelvic flexure of the ascending colon. During laparoscopy, an abdominal adhesion between the right uterine horn, the cecum, and the pelvic flexure was identified. The abdominal adhesions were either stretched with laparoscopic forceps used as a probe o...
Evaluation of postoperative peritoneal lavage in standing horses for prevention of experimentally induced abdominal adhesions. To evaluate the postoperative use of peritoneal lavage for prevention of experimentally induced intraabdominal adhesions in horses. Methods: Areas of serosal abrasion were created on the jejunum of 12 horses. Postoperatively, six horses had peritoneal lavage, and six horses did not (controls). The number of adhesions was determined at necropsy 2 weeks after surgery. Methods: 12 horses. Methods: Five sites of jejunal serosal abrasion were created in each horse. A 32 French thoracic catheter was placed into the right ventral aspect of the abdomen before closure of the abdominal incision. Treated...
Effect of omentectomy on adhesion formation in horses. To determine if omentectomy would decrease the frequency of postoperative intraabdominal adhesions. Methods: Retrospective study. Methods: 44 horses that had either two ventral median celiotomies or a ventral median celiotomy and a necropsy more than 4 days later; 19 of these horses had their omentum removed at the initial surgery. Methods: Data retrieved from the records included location and type of intraabdominal adhesions; location of the surgical lesion; relationship of adhesions to the surgical lesion; surgical procedures; duration of initial surgery; time interval between procedures; ag...
Closed one-stage functional end-to-end jejunojejunostomy in horses with use of linear stapling equipment. To use gastrointestinal linear stapling instrumentation to perform a closed one-stage functional end-to-end jejunojejunostomy in adult horses as an alternative to a stapled side-to-side jejunojejunostomy. Methods: Clinical outcome, anatomic and histological architecture, and anastomotic dimensions were determined at 2, 4, 8, 16, and 24 weeks postoperatively. Methods: 18 adult horses. Methods: The anastomosis and peritoneal cavity were inspected for adhesions. The diameter and circumference of the anastomosis and jejunum oral and aboral to the anastomosis were determined from digitized contrast...
Recurrent colic in the mature horse: a retrospective review of 58 cases. The clinical features of 58 horses presenting with recurrent colic examined over a 5 year period were reviewed. The horses were categorised into 3 groups on the basis of the history of colic episodes. Recurrent transient colic Group 1 was characterised by 3 or more episodes of transient colic (of apparently similar type) occurring within one month. Recurrent transient colic Group 2 was characterised by 3 or more episodes of transient colic occurring within one year. Recurrent prolonged colic was characterised by 3 or more episodes of prolonged colic occurring within one year. Fifteen horses we...