Disease treatment in horses encompasses a range of medical interventions and management strategies aimed at addressing various health conditions affecting equine species. These treatments can include pharmacological approaches, such as the administration of antibiotics, anti-inflammatory drugs, and antiparasitic medications, as well as non-pharmacological methods like physical therapy, dietary adjustments, and surgical procedures. The selection of appropriate treatments depends on the specific disease, its severity, and the individual needs of the horse. This topic brings together peer-reviewed research studies and scholarly articles that explore the efficacy, safety, and advancements in therapeutic options for equine diseases, providing insights into best practices and emerging trends in equine veterinary medicine.
Olsén L, Bremer H, Olofsson K, Bröjer J, Bondesson U, Bergh A, Nostell K, Broström H, Bengtsson B, Ingvast-Larsson C.The aim was to supply information about the possibility of replacing the procaine salt with the sodium salt for benzylpenicillin IM treatment in horse in order to diminish the risk for procaine adverse effects. In a crossover study eight horses were given 15 mg/kg sodium benzylpenicillin (Na-pc) twice daily or procaine benzylpenicillin (control) once daily IM for four days. The half-life of Na-pc was 1.9h, peak concentration was 14,600 ng/mL reached after about 23 min. Trough plasma concentration was 281 ng/mL and protein binding 62.8%. The fT>MIC for Staphylococcus aureus was 63% and 100% for...
Snyder LB, Wendt-Hornickle E.The purpose of this article is to update the community of veterinarians performing general anesthesia in horses on fluid therapy. The rationale behind intraoperative fluid therapy, fluid dynamics, and various fluid options (crystalloids, hypertonic saline, colloids) is discussed. Additionally, electrolytes (calcium, potassium, and sodium) are included in the discussion in relation to general anesthesia and intraoperative fluid management.
Deniau V, Depecker M, Bizon-Mercier C, Couroucé-Malblanc A.To compare the changes in splenic length and thickness and in packed cell volume (PCV) following detomidine or xylazine administration and subsequent epinephrine infusion. Objective: Spleen relaxation occurs following xylazine or detomidine administration and interferes with subsequent splenic contractile response to epinephrine. Methods: Randomized non-blinded crossover experimental study. Methods: 6 healthy adult mares. Methods: The mares received an intravenous (IV) epinephrine infusion (1 μg kg(-1 ) minute(-1) over 5 minutes) one hour after IV administration of detomidine (0.01 mg kg(-1) ...
Chung C, Wilson C, Timoney P, Adams E, Adams DS, Chung JS, Evermann JF, Shuck K, Lee SS, McGuire TC.Equine arteritis virus (EAV) causes contagious equine viral arteritis, characterized by fever, anorexia, conjunctivitis, nasal discharge, dependent edema, abortion, infrequent death in foals, and establishment of the carrier state in stallions. The World Organization for Animal Health (OIE) defines a horse as seropositive if the serum neutralization (SN) antibody titer is ≥1:4 to EAV. However, determining the SN titer is time-consuming and requires specific laboratory facilities, equipment, and technical expertise to perform. Furthermore, interpretation of the SN titer of some sera can be di...
Sabban S, Ye H, Helm B.The binding of immunoglobulin E (IgE) to its high-affinity receptor (FcɛRI) is the central protein interaction in IgE-mediated allergic reactions. The cross-linking of the IgE/FcɛRI complex, through cognate allergens, on the surface of mast cells and basophil cells results in mediator release, and thus leads to the symptoms of type I hypersensitivity responses in mammals. To develop a baseline value for subsequent equine anti-allergy drug and vaccine research, the interaction of equine IgE with its high-affinity FcɛRI receptor was investigated following the cloning and expression of equine ...
van Kasteren PB, Bailey-Elkin BA, James TW, Ninaber DK, Beugeling C, Khajehpour M, Snijder EJ, Mark BL, Kikkert M.Protein ubiquitination regulates important innate immune responses. The discovery of viruses encoding deubiquitinating enzymes (DUBs) suggests they remove ubiquitin to evade ubiquitin-dependent antiviral responses; however, this has never been conclusively demonstrated in virus-infected cells. Arteriviruses are economically important positive-stranded RNA viruses that encode an ovarian tumor (OTU) domain DUB known as papain-like protease 2 (PLP2). This enzyme is essential for arterivirus replication by cleaving a site within the viral replicase polyproteins and also removes ubiquitin from cell...
Dembek KA, Onasch K, Hurcombe SD, MacGillivray KC, Slovis NM, Barr BS, Reed SM, Toribio RE.The renin-angiotensin-aldosterone system (RAAS) and hypothalamic-pituitary-adrenal axis (HPAA) and their interactions during illness and hypoperfusion are important to maintain organ function. HPAA dysfunction and relative adrenal insufficiency (RAI) are common in septic foals. Information is lacking on the RAAS and mineralocorticoid response in the context of RAI in newborn sick foals. Objective: To investigate the RAAS, as well as HPAA factors that interact with the RAAS, in hospitalized foals, and to determine their association with clinical findings. We hypothesized that critical illness i...
Kaabia Z, Dervilly-Pinel G, Hanganu F, Cesbron N, Bichon E, Popot MA, Bonnaire Y, Le Bizec B.During last decades, the use of natural steroids in racing and food producing animals for doping purposes has been flourishing. The endogenous or exogenous origin of these naturally occurring steroids has since remained a challenge for the different anti-doping laboratories. The administration of these substances to animals is usually made through an intra-muscular pathway with the steroid under its ester form for a higher bioavailability and a longer lasting effect. Detecting these steroid esters would provide an unequivocal proof of an exogenous administration of the considered naturally occ...
Porzuczek A, Kiełbowicz Z, Haines G.In equine field practice, the diagnosis of small intestinal disorders is usually based on the presence of distended loops on rectal palpation and large volumes of reflux obtained after the passage of a nasogastric tube. Percutaneous abdominal ultrasound examination has been widely utilized in both human and small animal internal medicine in most cases of gastrointestinal discomfort. The purpose of this study was to identify which measurable parameters were important in reaching a diagnosis of small intestinal abnormality and determining treatment options. Horses of various age, sex and breed w...
Hamilton NA, Tammen I, Raadsma HW.Angiotensin converting enzyme (ACE) is essential for control of blood pressure. The human ACE gene contains an intronic Alu indel (I/D) polymorphism that has been associated with variation in serum enzyme levels, although the functional mechanism has not been identified. The polymorphism has also been associated with cardiovascular disease, type II diabetes, renal disease and elite athleticism. We have characterized the ACE gene in horses of breeds selected for differing physical abilities. The equine gene has a similar structure to that of all known mammalian ACE genes. Nine common single nuc...
Guidolin FR, Tambourgi DV, Guidolin R, Marcelino JR, Okamoto CK, Magnoli FC, Queiroz GP, Dias da Silva W.Crotalus durissus terrificus, C. d. collilineatus, C. d. cascavella and C. d. marajoensis are responsible minor but severe snake bites in Brazil. The venoms of these snakes share the presence of crotoxin, a neurotoxin comprising of two associated components, crotapotin and phospholipase A2 (PLA2). Treatment of the victims with specific antiserum is the unique effective therapeutic measure. The ability of anti-Crotalus antisera produced by the routine using crude venom to immunize horses or purified crotoxin and PLA2 as individual immunogens was compared. Antisera obtained from horses immunized...
Paillot R.Inactivated Parapoxvirus ovis (iPPVO) and Propionibacterium acnes (P. acnes) are currently used in equine medicine as immune-modulators for prophylactic treatment or adjunct to conventional therapy in order to improve immune defences, to prevent or treat infectious diseases. Their mode of action relies on a non-antigen specific interaction with the innate and/or adaptive immune responses. iPPVO stimulates and regulates cytokine secretion by leucocytes, while P. acnes acts primarily through the activation of macrophages. This report aims to describe their activity as immune-modulators and to su...
Goodrich LR, Phillips JN, McIlwraith CW, Foti SB, Grieger JC, Gray SJ, Samulski RJ.Osteoarthritis (OA) affects over 40 million people annually. We evaluated interleukin-1 receptor antagonist (IL-1ra) gene transfer in an equine model based on IL-1ra protein therapy which inhibits inflammation through blocking IL-1. Using the self-complementary adeno-associated virus (scAAV)IL-1ra equine gene as a starting construct, we optimized the transgene cassette by analyzing promoters (cytomegalovirus (CMV) versus chicken β-actin hybrid (CBh)), coding sequences (optimized versus unoptimized), vector capsid (serotype 2 versus chimeric capsid), and biological activity in vitro. AAV serot...
Moens Y.The mechanical ventilation of horses during anesthesia remains a crucial option for optimal anesthetic management, if the possible negative cardiovascular side effects are managed, because this species is prone to hypercapnia and hypoxemia. The combined use of capnography and pitot-based spirometry provide complementary information on ventilation and respiratory mechanics, respectively. This facilitates management of mechanical ventilation in conditions of changing respiratory system compliance (ie, laparoscopy) and when investigating new ventilatory strategies including alveolar recruitment m...
Andoh K, Takasugi M, Mahmoud HY, Hattori S, Terada Y, Noguchi K, Shimoda H, Bannai H, Tsujimura K, Matsumura T, Kondo T, Maeda K.A major immunogenic region of equine herpesvirus (EHV)-1 glycoprotein E (gE) was identified. Firstly, the various fragments of EHV-1 gE were expressed as fusion proteins with glutathione S-transferase (GST) in Escherichia coli and their antigenicities were compared by immunoblot analysis using sera from horses experimentally infected with EHV-1. Thirty-three amino acids of gE (a.a. 169-201) specifically and sensitively reacted with the antibodies induced by EHV-1 but not EHV-4 infection. The corresponding region of EHV-4 gE (a.a. 169-199) did not react with antibodies to EHV-1, indicating that...
Canisso IF, Gallacher K, Gilbert MA, Korn A, Schweizer CM, Bedford-Guaus SJ, Gilbert RO.The major objective of this study was to determine whether short-term preovulatory progestagen treatment of mares could effectively delay ovulation. Secondary objectives were to determine the effect such supplementation had on signs of estrus, follicular growth, postovulatory luteal function and pregnancy rate. Thirteen cyclic mares of different breeds were used in this study during the natural breeding season. Once mares were confirmed in estrus with a follicle of 35 mm in diameter, they were assigned in random order to receive no treatment (control), placement of a progesterone-impregnated c...
Tafese A, Jibat T, Aklilu N, Zewdu H, Kumsa B.A cross-sectional study was conducted to determine the prevalence and species composition of lice infesting horses in three agroecological zones in seven different districts in central Oromia from November 2011 to April 2012. For this purpose, a total of 420 horses were thoroughly examined for presence of lice. Collected lice were identified to species level under a microscope. The study showed an overall prevalence of 28.8 % (121/420) lice infestation on horses. We identified two spp. of lice on horses namely, Bovicola (Werneckiella) equi and Haematopinus asini with an overall prevalence of ...
Schauvliege S, Gasthuys F.Despite the use of balanced anesthesia and fluids, drugs for cardiovascular support are often needed in anesthetized horses. Antimuscarinics can be used to treat bradycardia unrelated to hypertension. Vasopressors can be useful when hypotension is caused by vasodilation and/or when the effect of fluids and inotropes is insufficient. In most cases, however, inotropes, including sympathomimetics, calcium salts, and phosphodiesterase inhibitors, are preferred. Of the β-sympathomimetics, dobutamine remains the agent of choice. Calcium salts are mainly useful in hypocalcemic patients. Phosphodiest...
Easley JT, Freeman DE.To describe successful surgical treatment of bilateral mucocele in an American Miniature horse using a single bone flap to approach right and left paranasal sinuses simultaneously. Methods: Clinical report. Methods: A castrated 6-year-old American Miniature Horse with a bilateral mucocele of the paranasal sinuses. Methods: A single bilateral frontonasal sinus flap was used in a standing procedure to access the left and right conchofrontal sinuses simultaneously to remove the mucous contents and to establish permanent drainage into the nasal cavities. Results: The novel procedure used in this h...
Klewitz J, Krekeler N, Ortgies F, Heberling A, Linke C, Sieme H.To assess pregnancy and live foaling rates after reduction of twin pregnancy via transvaginal ultrasound-guided aspiration (TUA) in mares and evaluate effects of gestational period, localization of conceptuses, fluid aspiration volume, and combination of TUA with embryonic or fetal puncture on these outcomes. Methods: Clinical trial. Methods: 44 mares pregnant with twins (25 to 62 days of gestation). Methods: TUA was performed in all mares and combined with embryonic or fetal puncture in 13. Follow-up ultrasonographic examinations were performed by referring veterinarians. Effects of gestation...
Bischofberger AS, Wereszka MM, Hadidane I, Perkins NR, Jeffcott LB, Dart AJ.To evaluate the effect of 3 laryngeal prostheses alone or in combination on rima glottidis area in horses. Methods: Experimental randomized design. Methods: Cadaveric equine larynges (n = 22). Methods: Three prostheses were preplaced in each of 14 larynges. Rima glottidis area was measured after loading each suture in 5 Newton (N) increments from 0 N to 35 N. In 8 larynges, the 3 prostheses were tied alone or in combination at a fixed load of 15 N and rima glottidis area measured. Results: Rima glottidis cross-sectional area increased as the load on each prosthesis increased with maximum area ...
Whitton RC, Mirams M, Mackie EJ, Anderson GA, Seeman E.Bone remodelling is inhibited by high repetitive loading. However, in subchondral bone of racehorses in training, eroded surface doubled in association with fatigue fracture and there was greater surrounding trabecular bone volume suggesting trabecular modelling unloads the bone focally, allowing damage repair by remodelling. Background: Remodelling replaces damaged bone with new bone but is suppressed during high magnitude repetitive loading when damage is most likely. However, in cortical bone of racehorses, at sites of fatigue fracture, focal porosity, consistent with remodelling, is observ...
Olive J, Vila T, Serraud N.To compare navicular bone marrow lesion (BML) conspicuity in the feet of horses as determined via 2 fat-suppressed MRI techniques, including standard short tau inversion recovery (STIR) and inversion recovery gradient echo (IRGE). Methods: Feet (n = 150) of horses with lameness referable to the distal portion of the digit. Methods: STIR and IRGE sequences were obtained prospectively in all feet with a standing low-field equine MRI system. Presence of a BML was ascertained by identification of a characteristic combination of marrow alterations in T1-weighted, T2*-weighted, T2-weighted, and STIR...
Renier AC, Kass PH, Magdesian KG, Madigan JE, Aleman M, Pusterla N.To determine clinical, laboratory analysis, and necropsy findings for equids with oleander toxicosis and to identify factors associated with outcome. Methods: Retrospective case series. Methods: 30 equids. Methods: Medical records of equids with detectable concentrations of oleandrin in serum, plasma, urine, or gastrointestinal fluid samples and equids that had not received cardiac glycoside drugs but had detectable concentrations of digoxin in serum were identified via a medical records database search. Descriptive statistics were calculated for medical history, physical examination, laborato...
Van Erck-Westergren E, Franklin SH, Bayly WM.Given that aerobic metabolism is the predominant energy pathway for most sports, the respiratory system can be a rate-limiting factor in the exercise capacity of fit and healthy horses. Consequently, respiratory diseases, even in mild forms, are potentially deleterious to any athletic performance. The functional impairment associated with a respiratory condition depends on the degree of severity of the disease and the equestrian discipline involved. Respiratory abnormalities generally result in an increase in respiratory impedance and work of breathing and a reduced level of ventilation that c...
Milwid RM, O'Sullivan TL, Poljak Z, Laskowski M, Greer AL.Contact networks can be used to assess disease spread potential within a population. However, the data required to generate the networks can be challenging to collect. One method of collecting this type of data is by using radio-frequency identification (RFID) tags. The OpenBeacon RFID system generally consists of tags and readers. Communicating tags should be within 10m of the readers, which are powered by an external power source. The readers are challenging to implement in agricultural settings due to the lack of a power source and the large area needed to be covered. OpenBeacon firmware wa...
Frye MA, Selders CG, Mama KR, Wagner AE, Bright JM.Rectilinear biphasic cardioversion was used in 2 horses with idiopathic sustained atrial fibrillation; 1 horse converted to sustained sinus rhythm. Variables that potentially affected outcome of the electrical cardioversion procedures in these horses included duration of arrhythmia, placement of cardioverter pads and paddles, serum electrolyte concentrations, and treatment with quinidine. Serum cardiac troponin I concentration, measured to determine whether the myocardium was damaged from the electrical shocks, was within the reference range in both horses after the procedure. Biphasic electri...
Witte TS, Bergwerff AA, Scherpenisse P, Drillich M, Heuwieser W.Endometritis is one of the major problems in the horse breeding industry. The use of antibiotics for treatment of endometritis in the mare is recommended as best practice. The intrauterine application of antibiotics, however, has been under discussion over the last years because of concerns about its efficacy. The systemic use of antibiotics has been considered more effective because of its better distribution within the uterus. The objective of the present study was to determine the concentration of ceftiofur derivates in serum and endometrial tissue after intramuscular administration. Specif...
Marley SE, Hutchens DE, Reinemeyer CR, Holste JE, Paul AJ, Rehbein S.Modern anthelmintic use in horses has decreased the prevalence of the large strongyles, which has in turn shifted the focus of parasitologists to the pathogenic importance of the small strongyles, tapeworms, and other parasites. These studies show that a combination product containing ivermectin and praziquantel allowed efficacious treatment of horses for nematode, cestode, and bot infections. The use of this combination product may be of special benefit to horses that are mainly kept outdoors and on grazing pastures.
Elliott J, Bailey SR.Equine laminitis has both fascinated and frustrated veterinary researchers and clinicians for many years. The recognition that many ponies suffering from pasture-associated laminitis have an insulin-dysregulated phenotype (endocrinopathic laminitis, EL) and that prolonged insulin and glucose infusions can experimentally induce laminar pathology and functional failure are seminal discoveries in this field. Researchers have studied the molecular basis for disease pathogenesis in models of EL, sepsis-related laminitis and supporting limb laminitis and generated much data over the last 15 years....
Turner TA.Navicular disease was diagnosed in 36 horses. Each horse was treated, using shoeing as the only major means of treatment. Phenylbutazone was used initially for 10 days after shoeing. Shoeing was designed to correct preexisting problems, enhance physiologic function of the foot, and ease breakover of the foot. The horses were evaluated over a period ranging from 12 to 54 months. The lameness improved in all horses. Thirty-one of the 36 horses treated were not lame when last evaluated. Shoeing was most effective when performed within 8 months of the first signs of lameness. Also, horses used for...
Calzetta L, Rogliani P, Mattei M, Alfonsi P, Cito G, Pistocchini E, Cazzola M, Matera MG.Equine airways represent a suitable ex vivo model to study the functional impact of pharmacological treatments on human chronic obstructive pulmonary disorders, such as asthma and chronic obstructive pulmonary disease (COPD). We aimed to characterize the pharmacological interaction between the long-acting muscarinic antagonist (LAMA) tiotropium and the long-acting β-agonist (LABA) olodaterol in equine airways. The effect of tiotropium and olodaterol, administered alone and in combination at the ratio of concentrations reproducing ex vivo the concentration-ratio delivered by the currently avai...
Launois T, González Hilarión LM, Barbe F, Leurquin C, Bihin B, Hontoir F, Dugdale A, Vandeweerd JM.We report a retrospective evaluation of intravitreal gentamicin (6 mg in 0.3 mL solution) injection in 71 horses with equine recurrent uveitis between 2010 and 2016. Aqueous flare and hyalitis were scored at the baseline in all horses, then at 15, 30, 60, 90, 180, 365, and 730 in 37, 46, 30, 25, 22, 18, and 11 horses, respectively. Forty-two animals had a global score of inflammation (sum of scores for aqueous flare and hyalitis) of zero at the last examination (number of re-examinations per horse ranged from 1 to 5). Among the 29 remaining horses, four were not reassessed after the interven...
Marti E, Horohov DW, Antzak DF, Lazary S, Paul Lunn D.The horse has been human kind's most important partner throughout history. Similarly, in the field of immunology, many critical scientific advances have depended on the horse. Equine immunology today is an active and important field of study, with a focus on control of many common infectious diseases and immunopathologic conditions of broad comparative interest. In 2001 two major equine immunology workshops were held, in Santa Fe, USA, and in Hortobagy, Hungary, with major sponsorship from the Havemeyer Foundation. This report summarizes the scientific themes and foci of those meetings.
Panzuti P, Rocafort Ferrer G, Mosca M, Pin D.Equine pastern vasculitis is an uncommon disorder in horses. Underlying causes are difficult to assess, especially bacterial infections. Conclusions: A 13-year-old French saddle gelding horse presented for evaluation of a six weeks history of pastern dermatitis. Histopathological examination of skin biopsy samples revealed small vessel vasculitis. A pure growth of a multidrug-resistant Pseudomonas aeruginosa (MRPA) was obtained from a deep skin biopsy. Clinical remission was observed after a six week course of enrofloxacin and lesions did not recur. Conclusions: To the best of the authors' kno...
Prescott JF, Srivastava SK, deGannes R, Barnum DA.A mild form of strangles caused by an atypical Streptococcus equi was recognized on a large horse breeding farm. The organism differed from most S equi isolates by disappearance of the mucoid capsule by 24 hours of culture, leaving a matt-type colony. Typically, the clinical signs were a transient (24-48 hour) fever, profuse nasal discharge, and anorexia. In about half the affected animals, there was moderate mandibular lymph node enlargement, and these glands usually ruptured or were drained. The use of a passive hemagglutination antibody test showed that subclinical infection was widespread ...
Fecteau KA, Haffner JC, Eiler H.The purpose of this study was to determine to what degree bacterial collagenase may digest human placentae compared to equine and bovine placentae. Placenta samples from human, equine and bovine were incubated with bacterial collagenase solution at various concentrations. The degree of hydrolysis and collagen breakdown was measured by the release of total proteins and hydroxyproline into the incubation media. Also, whole placentae were injected via umbilical cord arteries with collagenase solution (200 U/ml, 200 ml total volume in human and 1000 ml in equine) and hydrolysis determined chemical...
Lassen ED, Swardson CJ.In diseased animals, laboratory evaluations of erythrocytes, leukocytes, and hemostasis provide important information that contributes to either narrowing the list of potential diagnoses or to determining a specific diagnosis. To adequately interpret the results of these evaluations, normal erythrocyte and leukocyte kinetics and normal hemostatic function must be understood. In addition, knowledge of common diseases resulting in abnormalities of these laboratory tests and of typical changes in these tests caused by these diseases is vital. This article has reviewed normal erythrocyte and leuko...
Campoy L, Sedgwick SR.Procedural sedation has become popular for describing a semiconscious state that allows patients to be comfortable during certain surgical or diagnostic procedures. Sedation may be enhanced by locoregional anesthetic techniques to produce sufficient analgesia and muscle relaxation for surgery to occur. Sedation and local anesthesia for standing diagnostic and surgical procedures on the horse's head circumvents the potential complications of general anesthesia (particularly, complications related to recovery). However, the implementation of a locoregional anesthetic technique requires a thoroug...
Keller M, Krehon S, Stanek C, Rosengarten R.Specimens of hoof horn from 187 horses were examined for a possible relationship between clinically affected hooves and the occurrence of pathogenic fungi. Specimens were taken from the coronary band and from the stratum externum and medium of the coronary horn and transferred on to Sabouraud dextrose agar, with and without cycloheximide, and incubated at 28 degrees C. Dermatophytes and mould fungi were identified by their macroscopic and microscopic characteristics. The 732 isolates could be assigned to 26 species of moulds, two different species of the dermatophyte Microsporum and three diff...
Burger NC, Nesvadba J, Nesvadba Z, Busato A, Gottstein B.A cross-sectional field study on the prevalence of Dicrocoelium dendriticum was performed in the Emmental. The study included 211 bovines, 170 equines, 20 ovines, 46 caprines and 23 rabbits (from 119 farms). In addition, laboratory routine diagnostic data obtained from 2.840 animals--all originating from the same area of investigation--were assessed in the same way. The infection extent concerning the different animal species were the following: bovines 46%, equines 12%, ovines 30%, caprines 48% and rabbits 9%. Univariate analyses of baseline epidemiological data identified no significant risk...
Speirs VC, Reynolds WT.The diagnosis and successful surgical treatment of a diaphragmatic hernia in a 12 weeks old standardbred foal are described. The clinical syndrome in horses generally is contrasted with that seen in the foal described in this paper. Some of the factors contributing to the clinical signs are discussed.
van der Velden MA.During a seven year period, 51 cases of acquired inguinal herniation in 50 stallions were treated surgically. In 25 cases the herniated loop was ileal, in the other 26 it was jejunal. In cases of strangulation, the vaginal ring was enlarged by incising the peritoneum and transverse fascia. Closure of the superficial inguinal ring was advisable to prevent the hernia recurring. In all cases unilateral castration was performed. Laparotomy was carried out in 33 cases; 22 required intestinal resection and in four cases a bypass was made. Follow-up at least six months postoperatively indicated that ...