Intestinal surgery in horses involves surgical procedures performed on the horse's intestines to address conditions such as colic, obstructions, or strangulations. This type of surgery is a component of equine veterinary medicine focused on resolving gastrointestinal issues that cannot be managed through medical treatment alone. The surgical process may include resection, anastomosis, or bypass of affected intestinal segments. Post-operative care is critical, as horses are prone to complications such as adhesions and infections. This page compiles peer-reviewed research studies and scholarly articles that explore the techniques, outcomes, and post-operative management associated with intestinal surgery in horses.
Tate LP, Ralston SL, Koch CM, Everitt JI.Small intestinal resection (SIR) is not uncommonly done in surgical treatment of equine colic, but little is known about the long-term effects of SIR on horses and ponies. Twelve ponies, fed maintenance amounts of pelleted feed, were divided randomly into 4 treatment groups. D-Xylose absorption curves were recorded for each pony before surgical treatments were performed. Treatments consisted of control (ileal bypass) and 40%, 60%, or 80% SIR. D-Xylose absorption, serum electrolyte, and enzyme profiles for each animal were recorded once every 30 days for 180 days after surgical treatment, and t...
Bailey JV, Fretz PB.Two incidents of penetrating wounds into the abdominal cavity of horses are presented. In both events these had resulted in penetraton of the intestinal tract. Both animals had received only minimal veterinary attention in the acute stage and had survived with the formation of intestinal fistulae.Attempts at surgical repair resulted in failure in one animal and in closure of the fistula in the second with some subsequent cosmetic defect.
Barclay WP, Phillips TN, Foerner JJ.Intussusception associated with Anoplocephala perfoliata infection was found in 5 horses. The unusual types of intussusception and the presence of tapeworms at the leading edge of the intussuscipiens suggested tapeworms as the cause of the problem. Lesions attributable to tapeworm attachment on the mucosa were found to fit a mechanical model of intussusception. Treatment of two of the horses and some of their pasturemates with pyrantel pamoate caused elimination of intact tapeworms.
Moore JN, White NA, Berg JN, Trim CM, Garner HE.Experimental small intestinal strangulation obstruction was produced in anesthetized ponies. The limulus amoebocyte lysate test demonstrated the presence of endotoxin in the general circulation 60 and 120 minutes following restoration of mesenteric blood flow. Mucosal degeneration, with loss of villus epithelial cells, was demonstrated coincident with endotoxemia. The findings were consistent with an ischemia-mediated alteration in the intestinal barrier to endotoxin.
van der Gaag I, Tibboel D.Intestinal atresia was found in 29 animals and stenosis in five. Atresia was found in the duodenum in one pup; in the jejunum in nine calves, two lambs and one piglet; in the ileum in one pup, one lamb and one piglet; and in the colon in one foal, seven calves, one lamb, one piglet and three kittens. Stenosis was found in the duodenum of a foal, in the jejunum in two calves and one pup, and in both the ileum and the colon of a kitten. One lamb showed ileal atresia as well as ileal stenosis. We classified the atresia as type 1, membrane atresia (four cases); type 2, cord atresia (six cases); an...
White NA, Moore JN, Trim CM.Small intestinal strangulation obstruction (ISO) was produced in seven ponies (under pentobarbital-anesthesia) by arteriovenous ligation. Positive-pressure ventilation with room air was used to maintain arterial PCO2 at the initiation of the ISO. Biopsy materials obtained from affected intestines at various times were evaluated, using histopathologic examination and scanning electron microscopy. Mucosal and villus degeneration was graded 0 to V and compared with intestinal gross color, motility, and wall thickness. The mucosa at the tip of the villus was the first to be affected. Degeneration ...
Freeman DE, Koch DB, Boles CL.Volvulus of the jejunum and ileum in three horses was associated with intestinal strangulation in a mesenteric rent. The rent was in the jejunal mesentery at its point of attachment with an anomaly that was classified as a mesodiverticular band. The band also was attached to the dorsolateral surface of the jejunum, thus forming one side of a triangular hernial sac that was completed on the other side by the adjacent jejunal mesentery. Incarceration of a loop of small intestine in the hernial sac preceded rupture of the jejunal mesentery and subsequent intestinal strangulation. Surgical correct...
Hjortkjaer RK, Svendsen CK.Experimental closed loop small intestinal volvulus was studied in the anesthetized horse. Volvulus was simulated by ligation of the mesenterial veins to a segment of small intestine. Physical signs and hemodynamic, hematologic, clinical chemical, bacteriologic and peritoneal fluid values were examined. Compared to conscious horses anesthesia highly delayed and modified the clinical signs of shock (changes in mucosal colour, dehydration, decreased skin temperature, elevated pulse rate, low blood pressures) and of small intestinal volvulus (altered peristalsis, gastric dilation). Plasma glucose ...
Huskamp B.The paper considers the general principles of intestinal surgery in the horse and illustrates a theatre layout suitable for this purpose. The problems of locating and reducing obstructions of the small and large intestine are discussed, with particular emphasis on incarcerations of the small bowel and the techniques of jejunal and ileal re-implantation after bowel resection.
Reinertson EL.Thirteen horses and ponies were used to evaluate an anastomotic technique utilizing a modified Gambee suture pattern. The modified Gambee technique was compared with a single-row everting technique and a double-row inverting technique. The double-row inverting technique predisposed to intestinal obstruction and resulted in minimal adhesions. The everting technique predisposed to leakage of intestinal contents and subsequent peritonitis. Adhesions were formed at the site of the anastomosis to such an extent as to jeopardize the proper position of the bowel. The technique did not cause any lumin...
Boles C.Emergency equine abdominal surgery is easiest and most efficiently carried out with a team of surgeons. The surgical site should be as protected as possible by the use of sterile drapes and wound protectors. A ventral midline laparotomy incision has been found to be the most convenient approach to most equine intestinal obstructions. A standing laparotomy through the left paralumbar fossa gives adequate exposure for exploration of the abdomen and is, therefore, useful as a diagnostic tool. Horses tolerate having both ventral midline and left paralumbar laparotomy incisions well. If the cause o...
Crowhurst RC, Simpson DJ, McEnery RJ, Greenwood RE.Intestinal surgery in the foal is seldom necessary but some conditions in which it is essential are well recognized. The foal is a good surgical subject but success depends mainly on operating promptly before irreversible degenerative changes take place. Exploratory laparatomy is recommended whenever mechanical obstruction is suspected. Indications fall broadly into two main categories: 1. Cases arising from congenital defects. These form a miscellaneous group and present considerable difficulties in diagnosis and effective treatment. 2. Cases related to acute onset of obstruction, mainly due ...
Hélie P, Ammann VJ, Kervern I.A 6-year-old, standardbred mare was presented for colic of 12 h duration. Transrectal palpation revealed intestinal distension of unknown cause. The mare was euthanized. At necropsy, segmental jejunoileal incarceration and strangulation through an opening in the spleen was observed. This opening was considered to be a congenital defect.
Chanutin S, Bauck AG, Roberts JF, Denagamage TN, Freeman DE.Jejunocaecostomy (JC) is frequently required to bypass diseased ileum as a side-to-side (SS) anastomosis with blind end closure of the small intestine. The effects of the blind end closure method on the performance of the anastomosis have not been studied. Objective: To compare handsewn and stapled blind end closures of the ileum and jejunum. Methods: In vivo experiments. Methods: JC was performed with either Parker-Kerr (PK; 6 horses) or oversewn stapled technique (OS; 6 horses) to close jejunum and ileum for an SS anastomosis. At surgery, peritoneal fluid was analysed and various anastomotic...
Maire U, Genton M, Vitte-Rossignol A.A 16-year-old, French saddlebred horse was referred for examination because of colic signs, diagnosed with incarceration of the jejunum in a mesoduodenic rent, and subsequently treated surgically (with an end-to-end anastomosis of the jejunum and an enterotomy of the pelvic flexure). The horse initially recovered without complications; however, on the following day, it exhibited moderate signs of endotoxemia and severe serosanguineous discharge from the abdominal wound. Abdominal ultrasonography revealed substantial peritoneal effusion, necessitating the placement of an abdominal drain. The bl...
Freeman DE, Kilgallon EG.To determine if venous strangulation obstruction (VSO) of the distal half of the equine small intestine would increase length of that segment. Methods: Halothane-anesthetized horses were assigned randomly to 3 groups of 5 horses: Group 1 (controls)--the entire small intestine was measured and rubber-shod clamps were applied to mark each end of the most distal 50% of the small intestine; Group 2--same procedure, except that VSO was induced in the distal 50% of the small intestine for 180 minutes; and Group 3--same initial procedure, except that VSO was induced for 90 minutes and followed by rep...
MacHarg MA, Foerner JJ, Phillips TN, Barclay WP.The medical management of three horses with simple and strangulating small intestinal obstructions was unsuccessful and was therefore supported by surgical bypasses. Jejunocecostomies were used to treat horses with postoperative paralytic ileus that was unresponsive to medical management. These horses had abdominal pain, gastric distention, heart rate elevations greater than 60/minute, and small intestinal distention on rectal palpation. Two horses experienced weight loss which responded to bypass removal. The bypass effectively decreased the need for intravenous fluid administration and repea...
Hanson RR, Nixon AJ, Gronwall R, Meyer D, Pendergast J.Postoperative abdominal fluid changes were compared in 2 groups of horses; those undergoing double small-colon resection and anastomosis (n = 10) and those undergoing exploratory celiotomy alone (n = 5). Peritoneal fluid was collected before surgery and on postoperative days 1, 3, 5, and 7. Total and differential nucleated cell counts, RBC numbers, and total protein and fibrinogen concentrations were evaluated. In both groups, all values were significantly higher than normal on the first postoperative day (after small-colon resection and anastomoses, WBC = 130,350 +/- 23,310 cells/microliters,...
Barclay WP, McCracken RJ, Phillips TN, Foerner JJ.Chronic nongranulomatous intestinal inflammation was found during laparotomy in 7 horses. The clinical signs consisted of recurrent abdominal pain in all horses. Anti-inflammatory agents (corticosteroidal and nonsteroidal agents) appeared to be effective for controlling the signs. Surgical removal of the involved intestine also was effective. Nonocclusive or temporary mesenteric ischemia was proposed as a cause of the intestinal lesions.
Rose PL, Schumacher J, Taylor TS.An extensive stricture of the left dorsal colon in a Thoroughbred colt was resected and the colon was anastomosed. In two horses, circumferential strictures at the pelvic flexure 2.5 to 3 cm long were corrected with a modified Heineke-Mikulicz pyloroplasty technique. The horses were reported to be doing well at 6, 8, and 45 months, respectively.
Alonso Jde M, Rodrigues KA, Yamada AL, Watanabe MJ, Alves AL, Rodrigues CA, Hussni CA.Heparin is routinely administered in postoperative abdominal surgery aiming to prevent adhesions formation; however, there is no consensus indicating its effectiveness. This study evaluated the effect of heparin on peritoneal reactivity after abdominal surgery, through the association between peritoneal fluid features and ultrasonographic and laparoscopic examination. Ten adult horses were used: control group (CG) and treated group (TG). Both groups underwent laparotomy and small colon enterotomy. TG received subcutaneous heparin at 150 IU/kg every 12 hours for 5 days. The animals underwent ...
Sloet van Oldruitenborgh-Oosterbaan MM, van der Velden MA.A review of displacements and surgery of the large colon is given on the basis of two cases. A four-year-old Dutch Warmblood mare was referred, one week before foaling, for colic of twelve hours duration. At rectal palpation a large uterus was found, but no cause for the colic. Laparotomy revealed a colonic volvulus and resection of about 75% of the large colon was necessary. A dead foal was born five days postoperatively, but the mare recovered well. A nine year-old Dutch Warmblood stallion with a history of frequent colic had been treated for nephrosplenic entrapment three times. Resection o...
Mackey VS, Pascoe JR, Peterson PR.Anastomotic leakage was noted to occur at the junction of the staple lines used to create the stoma during small intestine side-to-side anastomosis. The anastomosis was performed in a clinical equine patient by joining the lateral surfaces of the intestinal segments using a gastrointestinal anastomosis stapling instrument (GIA). The cause of this problem was investigated by performing six anastomoses in the jejunum of a single anesthetized adult horse using the GIA; three anastomoses were created by joining the antimesenteric edges of the bowel segments and three anastomoses were created by jo...
Anderson SL, Blackford JT, Kelmer SG.This study describes the outcome and complications in horses that had a closed, one-stage, stapled, functional, end-to-end (COSFE) jejuno-ileal anastomosis (JIA) following resection of compromised small intestine. Medical records were reviewed to identify all horses that had a COSFE JIA performed during exploratory laparotomy and to determine post-operative complications and final outcome. All 5 horses that were identified had successful COSFE JIA with resection of various amounts of distal jejunum and proximal ileum. Post-operative ileus occurred in 1 of the 5 horses. All horses survived at l...
Averay K, van Galen G, Ward M, Verwilghen D.Equine small intestinal resection and anastomosis is a procedure where optimizing speed, without compromising integrity, is advantageous. There are a range of different needle holders available, but little is published on the impact surgical instrumentation has on surgical technique in veterinary medicine. The objectives of this study were to investigate if the needle holder type influences the anastomosis construction time, the anastomosis bursting pressure and whether the bursting pressure is influenced by the anastomosis construction time. Single layer end-to-end jejunojejunal anastomoses w...
Hanson RR, Nixon AJ, Calderwood-Mays M, Gronwall R.In an attempt to determine the best method for surgical removal of devitalized small colon lesions, 12 horses underwent a double small colon resection and end-to-end anastomosis. In 4 horses (study 1), an appositional single-layer (APP-1) suture pattern was compared with an inverting 2-layer (INV-2) suture pattern. In 8 horses (study 2), an appositional 2-layer (APP-2) suture pattern was compared with the INV-2 suture technique. Polydioxanone suture (size 1-0), was used. Horses were evaluated at necropsy 3, 10, 14, 28, or 56 days after surgery. Postoperative complications (peritonitis, impacti...
Grulke S, Salciccia A, Arévalo Rodríguez JM, Sandersen C, Caudron I, Serteyn D, de la Rebière de Pouyade G.Epiploic foramen entrapment (EFE) of small intestine is a severe cause of strangulating small intestinal obstruction (SSI) with long-term survival seeming lower than for other causes of SSI in horses. Different techniques via laparoscopy or laparotomy for epiploic foramen (EF) closure have been developed. This study describes a technique of peroperative mesh closure of the EF in clinical cases and their long-term follow up. In the study period of 5.5 years, 36 horses were admitted to the clinic with EFE. Of these, 17 horses had peroperative mesh closure, with resection anastomosis in 4 cases a...
Bristol DG, Cullen J.An inverting, triangulated, stapled, end-to-end anastomosis technique was evaluated in the jejunum of four horses. None of the horses showed evidence of gastrointestinal disturbance after surgery; however, stricture and adhesion formation were pronounced in three animals examined 10 days, one month, and two months after surgery. The animal examined four months after surgery had no adhesions present at the anastomosis, and only mild narrowing of the intestinal lumen. Histologic examination of the anastomoses showed lack of a normal mucosal lining in some examined sections up to two months posts...
Verhaar N, de Buhr N, von Köckritz-Blickwede M, Dümmer K, Hewicker-Trautwein M, Pfarrer C, Dengler F, Kästner S.Hypoxia inducible factors (HIF) are widely researched in human medicine for their role in different disease processes. The aim of this study was to investigate the expression and distribution of HIF in experimental small intestinal ischemia in the horse. Unassigned: In 14 horses under general anesthesia, segmental jejunal ischemia with 90% reduction in blood flow was induced. The horses were randomly divided into two groups of seven horses, one subjected to ischemic postconditioning (IPoC) by delayed reperfusion, and a control group (group C) undergoing undelayed reperfusion. Intestinal sample...
Biasutti S, Dart AJ, Dart CM, Uquillas E, Jeffcott LB.A newborn foal was referred for evaluation because it had not passed meconium, despite the administration of four enemas. Abdominal radiographs and ultrasound scans showed generalised gaseous distension of the intestine and there was no observable meconium in the colon. Positive contrast colography showed contrast medium extending to the transverse colon. An exploratory laparotomy confirmed the absence of the left and right dorsal colon and the pelvic and diaphragmatic flexures. An end-to-side anastomosis of the left ventral colon to the midpoint of the small colon was performed. The foal reco...
Bertone AL, VanSoest PJ, Johnson D, Ralston SL, Stashak TS.Fecal excretion of a particulate marker, ytterbium (Yb), was evaluated in 9 horses before surgery and 3 weeks, 3 months, and 6 months (4 trials) after sham-operation (group 1; n = 3) or extensive large colon resection (group 2; n = 6). Fecal excretion curves of total Yb excretion, loge Yb excretion, % Yb excretion, loge % Yb excretion, and cumulative % Yb excretion were evaluated, and kinetic analysis was performed on the loge Yb excretion curves to detect mixing pools and to calculate the fractional rate of particulate passage, turnover rate, and pool size. Calculations were performed to dete...
Southwood LL, Lindermann J, Zarucco L, Driessen B, Olander H, Habecker P, Birks EK, Frisbie DD.Growth factors (GF) are important for maintenance and repair of intestinal mucosal structure and function, but there have been no studies investigating growth factor (GF) or growth factor receptor (GF-R) mRNA expression in the intestine of horses with large colon volvulus (LCV). Objective: (1) To determine mRNA expression for epidermal growth factor (EGF), EGF receptor (EGF-R), insulin-like growth factor-I (IGF), IGF receptor (IGF-R), vascular endothelial growth factor (VEGF) and VEGF receptor (VEGF-R) in the intestine of horses with an LCV compared to normal intestine. (2) To measure the corr...
Bertone AL, Cockerell GL, Lee RE, Stashak TS.Light microscopy, morphometry, and scanning electron microscopy were used to examine the mucosal morphologic features of 7 intestinal specimens (3 from the small intestine; 4 from the large intestine) from each of 8 horses 1 year after sham operation (group 1; n = 3) or extensive large-colon resection (group 2; n = 5). Qualitative light microscopic examination did not reveal differences between groups, but morphometry revealed significantly (P less than 0.05) greater intercrypt area and distance in horses with colon resection and this was most pronounced in the cecum and remaining right ventra...
Sullins KE, Stashak TS.Six normal adult horses had large colon resections at the sternal and diaphragmatic flexures. Stainless steel staples were used to close the stumps of the dorsal and ventral colons in all six. Intestinal continuity was restored with a side-to-side anastomosis of the dorsal and ventral colons. Three of these anastomoses were performed with staples, and three with a double inverting suture pattern. After one month, the horses were surgically reevaluated, and the anastomotic sites were examined. There was no significant difference between the stoma sizes in the two groups. No complications were o...
Bertone AL, Toofanian F, Stashak TS.Lactase, maltase, sucrase, and alkaline phosphatase activities were determined in the intestinal mucosa from 3 locations in the small intestine and 4 locations in the large intestine 1 year after extensive large-colon resection (group 1; n = 5) and 1 year after sham operation (group 2; n = 3) in horses. Lactase, maltase, and sucrase activities were similar (P greater than 0.05) between group-1 and group-2 horses in all locations measured in the intestinal tract. Alkaline phosphatase activity in the remaining large colon of group-1 horses was significantly (P less than 0.05) greater than the ac...
Van Hoogmoed L, Snyder JR.Four horses were evaluated for clinical signs consistent with small intestinal disease. During exploratory surgery, primary hematomas in the mesentery were found in 2 horses. The third horse developed a hematoma secondary to a mesenteric rent, whereas in the fourth horse, a hematoma developed secondary to strangulation of the bowel by a mesenteric lipoma. Two horses were euthanatized at surgery, because the extensive nature of the hematoma precluded ligation and there was substantial risk of continued hemorrhage postoperatively. The remaining horses recovered from surgery but developed complic...
Gandini M, Cerullo A, Gallo L, Iussich S, Minoli L, Giusto G.To describe a technique for a side-to-side jejunocecal anastomosis in horses using radiofrequency thermofusion (TF) of the intestines supported by a Cushing oversew and to compare this anastomosis to handsewn and stapled techniques. Methods: Ex vivo study. Methods: Intestinal tracts from 24 slaughtered horses. Methods: A radiofrequency device was used to perform a jejunocecal anastomosis (Group RFA). The construction time and bursting pressure of this construct were compared with those of a hand-sewn double layer (Group HS) and stapled anastomoses (Group ST) without oversew of the staple line....
Wawrzeńska M.In this paper, the effect of ascorbic acid on motoric activity of the intestines of rabbits, pigs, cows, sheep and horses has been determined, and a possible participation of the adrenogenic system in this mechanism has been shown. In experiments in vitro the motility of the duodeum, jejunum, caecum and colon in the animals mentioned abowe was recorded by the method of Magnus after administration of ascorbic acid. Diastolic reactions were observed in all animals, which were much greater in small intestines than in large ones. To elucidate the diastolic mechanism under the influence of ascorbic...
Bladon BM, Hillyer MH.Extensive resection of the ileum of the horse, using automated stapling equipment followed by a stapled jejunocaecostomy, without closure of the mesenteric defect, was evaluated prospectively as a surgical treatment for lesions involving the distal small intestine. Of 153 horses treated surgically for colic, 10 horses with strangulating lesions involving the distal ileum were treated by extensive resection and jejunocaecal anastomosis leaving a residual mesenteric defect. These were compared with 12 horses with jejunoileal lesions treated by jejunocaecal anastomosis with closure of the mesente...
Whitehair KJ, Parker JE, Smith GN, Adams SB, Bottoms GB.Serum levels of type III procollagen peptide (P-III-P) were measured by radioimmunoassay in clinically normal adult ponies (n = 15) and horses (n = 10). The mean serum levels of P-III-P from the ponies, 10.4 +/- 2.9 (SD) ng/mL, and the horses, 12.2 +/- 2.6 (SD) ng/mL, were not significantly different. Segments of jejunum were made ischemic to induce fibrous peritoneal adhesions in two ponies, and serum P-III-P levels were measured on days 4, 5, 7, 14, and 21. An exploratory celiotomy on day 21 revealed that the ischemic injury had induced fibrosis of the mesentery and bowel, but no adhesions h...
Erkert RS, Crowson CL, Moll HD, Bentz BG, Confer AW, Blaik MA.A 4-year-old Thoroughbred stallion was referred for signs of mild to moderate colic, anorexia, and decreased water intake of 3 weeks' duration. Ultrasonographic examination revealed an intussusception, the most common of which would be a cecal inversion or ileocecal intussusception. Surgical exploration identified an ileocecocolic intussusception with extension of the intussusceptum into the right ventral colon; however, the cause of the intussusception could not be identified. The intussusception could not be surgically corrected, and the horse was euthanatized. A side-to-side jejunocecostomy...
Lisowski ZM, Lefevre L, Mair TS, Clark EL, Hudson NPH, Hume DA, Pirie RS.Studies in rodents and humans have demonstrated that intestinal manipulation or surgical trauma initiates an inflammatory response in the intestine which results in leucocyte recruitment to the muscularis externa causing smooth muscle dysfunction. Objective: To examine the intestinal inflammatory response in horses undergoing colic surgery by measuring relative differential gene expression in intestinal tissues harvested from surgical colic cases and control horses. Methods: Prospective case-control study. Methods: Mucosa and muscularis externa were harvested from healthy margins of resected s...
