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.
Littlejohn A.The mortality following operations for intestinal obstructions in horses decreased from 80 per cent during the period 1849-1913 to 22 per cent during the period 1934-1964. Mortality following operations for high intestinal obstructions was greater than for low intestinal obstructions, and the mortality following operations for strangulating obstructions was more than twice as great as the mortality following simple obstructions. The most frequent cause of death following operations was failure to correct the causal condition, or subsequent impaction.
The anaesthesia techniques most frequently...
To document morphologic changes that occur in equine intestinal serosa after experimentally induced ischemia and subsequent reperfusion (jejunum, ascending colon) or after intraluminal distention and decompression (jejunum). Methods: Morphologic effects of ischemia-reperfusion or intraluminal distention-decompression determined on the serosal layer of the equine jejunum. The large colon serosa was evaluated after ischemia-reperfusion injury. Methods: Seven adult horses. Methods: After induction of general anesthesia and ventral median celiotomy, ischemia was created by arteriovenous (AVO) and ...
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...
Jacobs CC, Stefanovski D, Southwood LL.To determine whether perioperative variables can be used to differentiate a medical vs a surgical reason for postoperative reflux (POR) after small intestinal (SI) surgery in horses. Methods: Retrospective study. Methods: Horses >1 year of age that recovered from SI surgery and had POR. Methods: Medical records of horses that underwent SI surgery and developed POR from 2009-2015 were reviewed. Surgical reasons for POR were defined as an anastomosis complication, mechanical obstruction, or nonviable intestine identified at repeat celiotomy/necropsy. A medical reason for POR was presumed wh...
Sandh G.The author has modified a surgical technique, which was originally developed at the turn of the century, for the aseptic establishment of an intestinal anastomosis. The principle of this technique, known as the "cutting thread" principle, was that a loop of thread was introduced into the lumen of each of two approximated loops of intestine. After suturing the two loops of intestine together around the intraluminal parts of the thread, the latter was used as a "wire-saw" to create a stoma between the two intestinal loops. The author modified the method in such a way that the cutting could be pe...
Hackett MS, Hackett RP.Ten young horses with signs of simple partial obstruction of the small intestine were found upon surgical exploration of the abdomen to have chronic intussusception of the distal ileum into the cecum. Poor general physical condition, intermittent or continual abdominal pain of varying degree, depression, and poor appetite were consistent clinical findings. Rectal palpation in eight animals was suggestive of an incomplete or intermittent obstruction of the small intestine. Laboratory determinations were not helpful in making a diagnosis. Dilatation and hypertrophy of the distal jejunum and ileu...
Matsuda K, Shimada T, Kawamura Y, Sakaguchi K, Tagami M, Taniyama H.A 2-year-old Thoroughbred horse presented with acute onset of colitis, and the intussuscepted jejunum was surgically resected. A transmural mass protruding into the lumen was found at the leading edge of the intussusceptum. Based on histological and immunohistochemical examinations, the mass was diagnosed as diffuse large B-cell lymphoma with metastasis to the mesenteric lymph nodes. Anatomical localization of the mass in the intussusception and absence of other obvious underlying diseases indicated that the intussusception had occurred in association with the mass. To our knowledge, this case...
Gandini M, Giusto G.In jejunocaecal anastomosis leaving a necrotic ileal stump has been implicated in complications and poor outcomes. Elective inversion of the necrotic stump using a nasogastric tube has been previously described, although this procedure can be cumbersome and can cause caecocolic orifice occlusion. Objective: To describe the use of a new device for elective inversion of necrotic ileal stumps. Methods: Case report. Methods: Details of the four horses that underwent intestinal resection and anastomosis with elective inversion of the ileal stump were retrieved from their medical records. For each c...
Veerasammy B, Gonzalez G, Báez-Ramos P, Schaaf CR, Stewart AS, Ludwig EK, McKinney-Aguirre C, Freund J, Robertson J, Gonzalez LM.Intestinal epithelial stem cells (ISC) are responsible for epithelial regeneration and are critical to the intestine's ability to regain barrier function following injury. Evaluating ISC biomarker expression in cases of small intestinal strangulation (SIS) may provide insight into clinical progression. Objective: Intestinal resection margins from cases of SIS were evaluated to determine if (1) evidence of injury could be identified using histomorphometry, (2) ISC biomarker expression was decreased in the proximal resection margin compared to control and distal resection margin, and (3) the ISC...
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...
Hurcombe SD, Roessner HA, Klein CE, Engiles JB, Hopster K.Jejunal vascular ligation is an essential step in performing jejunojejunostomy. Hand sewn ligation is typically used and can increase operative time with long sections of bowel to be removed. Nylon cable ties (NCT) have been used for vascular ligation in horses but are yet to be investigated for application on the mesenteric vasculature of the gastrointestinal tract. Our objective was to evaluate the efficacy and short-term safety of NCT jejunal mesenteric vessel ligation in healthy horses. Eight healthy adult horses underwent midline celiotomy. A segment of jejunal mesentery was identified (â...
Pratt SM, Christian JA, Paige Jackson L, Hawkins JF, Sojka JE.A 16-year-old castrated male Arabian horse was presented to the Purdue University Veterinary Teaching Hospital with a 4-hour history of colic. Initial examinations provided strong evidence for small intestinal obstruction. Abdominal surgery revealed a strangulating lipoma, and 25 feet of small intestine were resected. Postoperatively, the horse developed obstructive ileus due to adhesion formation, which required a second laparotomy. During and after surgery, the abdomen was lavaged with sodium carboxymethylcellulose (CMC). One week after the second surgery, evaluation of peritoneal fluid reve...
Kucera CR, Stranahan LW, Hughes F, Blikslager AT, Gonzalez LM.Progenitor cells play critical roles in epithelial repair following ischaemic injury. Protein biomarkers have been used to identify intestinal progenitor cell subpopulations. This study aims to determine if a critical number of intestinal progenitor cells can predict tissue viability and survival to discharge of large colon volvulus (LCV) cases. Objective: The objectives were to 1) identify intestinal progenitor cell subpopulations using biomarkers: proliferating cell nuclear antigen (PCNA), sex determining region Y box 9 (SOX9), phospho-histone H3 (PHH3) and Ki-67, 2) define cut-off values fo...
Giusto G, Cerullo A, Gandini M.Transillumination has been described in human surgery to improve vessel visualization but has not been described in horses. Since the equine mesocolon contains a great amount of fat which restricts visualization of the vessels, this technique could be useful during small colon resection. To describe transillumination of the mesocolon to provide an improved vessel identification during resection and anastomosis of the small colon in horses. Data of horses that underwent resection and anastomosis of small colon were recorded. Two transillumination techniques were used during resection and anasto...
Giusto G, Tramuta C, Caramello V, Comino F, Nebbia P, Robino P, Singer E, Grego E, Gandini M.The objective of this study was to investigate whether cleaning surgical materials used to close pelvic flexure enterotomies with a wet sterile gauze will reduce contamination and whether the use of a full thickness appositional suture pattern (F) or a partial thickness inverting (or Cushing) suture pattern (C) would make a difference in the level of contamination. Large colon specimens were assigned to group F or C and divided into subgroups N and G. In group G, a wet sterile gauze was passed over the suture material, another over the instruments, and another over the gloves. In group N, no t...
Watkins A, Engiles J, Long A, Brandly J, Hopster K.Large colon volvulus is a cause of colic in horses with high morbidity and mortality when not promptly treated. More treatment options are needed to improve the outcome of these cases by protecting against the damage caused by ischaemia and reperfusion injury. Objective: To determine the effect of preconditioning with dexmedetomidine prior to induction of ischaemia-reperfusion (IR) injury in a large colon volvulus model in the horse. Methods: Randomised blinded in vivo experiments. Methods: Horses received either a dexmedetomidine (DEX) or saline (CON) constant rate infusion (CRI) immediately ...
Azizi S, Mazaheri-Khameneh R, Davoodi F, Gooran MM, Ghoreishi SS, Mozaffari N, Dalir-Naghadeh B.In this case report, we present an unusual clockwise torsion of left colon around mesenteric root in a 10-month-old Arab filly, highlighting the clinical presentation, diagnostic approach and successful surgical intervention. A 10-month-old Arab filly weighing approximately 250Â kg was referred with signs of acute abdominal pain. The history revealed anorexia, restlessness and severe abdominal pain that had begun the previous day. The local practitioner had previously administered flunixin meglumine, an analgesic, but it proved ineffective in relieving the pain. Upon physical examination, the ...
St Blanc MP, Mirza MH, Riggs LM, Leise BS.The aim of the study was to evaluate time to closure, bursting pressures and luminal diameters of a single and double-layer end-to-end anastomoses in normal equine descending colon. Methods: Experimental study. Methods: Eight adult horses. Methods: Four segments of descending colon from each horse were randomly assigned to a control (n = 8, CON), one-layer (n = 12, group 1; continuous Lembert pattern), or two-layer group (n = 12, group 2; simple continuous oversewn with Cushing pattern). Anastomoses were performed, and time to closure and luminal diameter were measured. Bursting pr...
Kopec EK, Stevens M, Crowe O, Wright C, Suthers J.The aim of the present study was to investigate the long-term survival and postoperative complications in horses that had undergone small intestinal resection and a modified anastomosis technique using a partially stapled, functional end-to-end anastomosis. Methods: Observational retrospective case series. Methods: A total of 25 horses underwent small intestinal resection and a partially stapled, functional end-to-end anastomosis. Methods: A modified technique to create a partially stapled, functional end-to-end anastomosis is described. The clinical case records of all horses that fulfilled t...
Verhaar N, Hammer E, Reineking W, Hewicker-Trautwein M, Geburek F.To compare the practicability and tissue sample quality between different intestinal biopsy techniques. Methods: Experimental, randomized ex vivo study. Methods: Small intestine of nine horses. Methods: Four different biopsy techniques were evaluated in the aboral jejunum and the ileum within 1 h after euthanasia. One segment was used as control (C), and the applied techniques included an 8 mm biopsy punch (BP), transverse wedge resection (TW), longitudinal wedge resection with transverse closure (LW) and a longitudinal sample using Eppendorfer biopsy forceps (EF). Defects were closed using ...
Barton CK, Hassel DM, Anders K, Weir TL.A major cause of morbidity and mortality in horses with large colon obstructive lesions is injury to the colonic mucosal barrier from ischemic injury. Since butyrate has been shown to play a critical role in the maintenance of a healthy mucosal barrier, it may play a role in the recovery process. This study's objective was to determine whether the differences in butyrate concentrations existed between horses with surgical large colon obstructive lesions and healthy horses both during and after surgery. Eleven horses presenting with surgical colic lesions were enrolled; colonic samples were acq...
Troillet A, Scharner D.Cecocolic intussusceptions are a rare condition of acute colic in horses requiring immediate surgical intervention due to persistent uncontrollable pain and ongoing ischemic cecal necrosis. Particularly in cases where reduction of the intussusception is surgically not feasible surgical interventions such as partial typhlectomy through colotomy (partial cecal amputation) combined with or without cecal bypass techniques are described. Alternatively, surgical interventions can also be performed without partial typhlectomy via incomplete bypass ileocolostomy. Information regarding applicable techn...
Moyer EK, Bauck AG, Denagamage T, Freeman DE.To compare end-to-side (ES) and side-to-side (SS) jejunocecostomy (JC) in healthy horses. Methods: Experimental study in vivo. Methods: A total of 14 healthy adult horses underwent ventral midline celiotomy, a resection, and either an ES (n = 7) or stapled SS (n = 7) JC. Methods: Surgical times and the external lengths of completed anastomoses were measured. Physical examinations and pain scoring were performed every 6 h for 5 days, then once daily until euthanasia and necropsy 28 days postoperatively. Results: The anastomosis was completed more rapidly (p < .002) with the SS...
Baldwin CM, Gillen A.To evaluate three different jejunal transection angles for end-to-end jejunojejunostomies, comparing construction time, lumen size, and suture number. Methods: Ex vivo cadaver study. Methods: Eight euthanized horses each had three mid-jejunal specimens harvested. Methods: Jejunal segments were assigned to one of three groups (A30, A45, and A60) and transected at 30, 45, or 60°, respectively. Following transection, a standardized handsewn single-layer interrupted modified Lembert anastomosis was performed, and construction time and number of sutures placed were recorded. Anastomotic index (AI)...
Chanutin SS, Elliott CRB, Fielding AS, Brown PM, McCreary CA, Bennet ED, Davis W.To provide performance data of warmblood jumping horses following colic surgery. Unassigned: This retrospective case series reviewed clinical records of 5 equine hospitals with the inclusion criteria of warmblood horses undergoing colic surgery between January 1, 2011, and December 31, 2021, surviving to discharge, and being registered as a hunter or jumper with the US Equestrian Federation. Clinical data included age, sex, and lesion type. Performance data included discipline, jump height, number of starts, number of wins, and number of placings. Pre- and postoperative data were analyzed sepa...
Carvalho BVL, de Souza MCN, Avanza MFB, Teixeira RBC, Silva JRB, da Silva Cardoso T, Novais LGES, de Oliveira Monteiro FD, Viana RB, Monteiro BM....Access to the equine cecum is required for various therapeutic and experimental procedures, including decompression, fluid therapy, and transfaunation. Traditional approaches via laparotomy are highly invasive. This study aimed to describe a minimally invasive, laparoscopically assisted technique for cecal cannulation in standing horses. Unassigned: Seven horses underwent the procedure under sedation and paravertebral anesthesia. Two right flank accesses were created: a 10-mm laparoscopic port for visualization and a 2-cm minilaparotomy for cecal exteriorization. A Foley catheter was inserted ...
Willette J, Guinn A, Munsterman A.Impactions of the jejunum are rarely described in the literature. The current case series describes six cases of adult horses with jejunal impactions with feed material diagnosed by exploratory celiotomy. Horses underwent exploratory celiotomy based off of their degree of pain despite medical management and concerns for a primary strangulating small intestinal lesion. All jejunal impactions were relieved via manual decompression of the impaction into the cecum. None of the cases underwent a resection or anastomosis at the site of impaction. All horses were treated with gastroprotectants (omepr...
Migliorisi A, Nottle B, Smanik LE, Nout-Lomas YS, Hassel DM.To (1) compare total nucleated cell count (TNCC) and neutrophil-to-lymphocyte ratio (NLR) at admission between horses with medically managed, large intestinal (LI) and small intestinal (SI) surgical colic; (2) compare TNCC and NLR between survivors and nonsurvivors; and (3) investigate associations between TNCC, NLR, surgical intervention, and outcome. Methods: Case-control study. Methods: Single, academic institution. Methods: A total of 341 adult horses diagnosed with noninfectious medical or surgical colic. Results: Admission TNCC did not differ between the medical and combined surgical gro...
Paganelli GC, Schott HC.Small intestinal (SI) distension and gastric reflux (GR) are common in horses with mechanical and functional ileus. Removal of GR results in fluid/ion losses. Objective: 1) Determine the capacity of healthy SI; 2) measure ion concentrations in normal SI fluid, GR, or fluid from SI undergoing resection. The authors hypothesized that Na and Cl concentrations would be lower and higher, respectively, in GR as compared to SI fluid from healthy horses, while there would be little difference in K concentration. Methods: Observational study: two to 15 meters of SI from 15 horses were distended with wa...
