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Topic:Intestinal Surgery
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.
Complications of celiotomy incisions in horses. Complications of celiotomy incisions were evaluated retrospectively in 274 horses that survived at least 1 month after surgery, or died or were euthanatized within 1 month of surgery, as a direct result of these complications. Horses were divided into four groups; group A, a ventral median celiotomy for intestinal disease; group B, ventral median celiotomy for nonintestinal disease; group C, repair of an umbilical hernia; and group D, celiotomy in a region other than the midline. Specific incisional complications were peri-incisional edema, drainage, incisional abscess, suture sinus, and dehis...
Repair of a full-thickness gastric rupture in a horse. A 14-year-old Thoroughbred broodmare was evaluated for signs of mild to moderate abdominal pain of 5 hours' duration. Exploratory celiotomy revealed a 20 x 8-cm subserosal hematoma associated with a focal serosal perforation overlying a muscular tear along the parietal surface of the stomach. The odor of intestinal tract gas was detected, but gross contamination of the abdomen was not evident. Concurrent partial volvulus of the small intestine was evident. Removal of the large colon from the abdomen appeared to coincide with propagation of the serosal perforation to a full-thickness gastric re...
Uterine torsion associated with small intestinal incarceration in a mare at 126 days of gestation. A mare at 126 days of gestation was examined because of signs of abdominal pain. The cause of abdominal pain could not be determined by physical examination. Lack of response to analgesics and small intestinal distention on palpation per rectum prompted exploratory celiotomy. Small intestine was found to be entrapped by the uterus, which had undergone torsion. The uterus was returned to its correct position, and the small intestine was decompressed. After surgery, the mare was treated with orally administered progestin to prevent abortion. The mare recovered and delivered a live foal at 354 da...
Intraperitoneal use of sodium carboxymethylcellulose in horses undergoing exploratory celiotomy. The effect of intraperitoneal sodium carboxymethylcellulose (SCMC) administration on clinical outcome and survival was evaluated in horses undergoing exploratory celiotomy for acute gastrointestinal disease. Comparison of variables was made retrospectively between 44 horses that had SCMC and 92 horses (controls) not treated with SCMC. Mean age, body weight, heart rate, packed cell volume and plasma total protein of horses at admission, and convalescent period were not significantly different between control and SCMC groups. No significant differences were noted between control horses and SCMC ...
[Displacement and resection of the ascending colon in the horse: a literature review on the basis of 2 cases]. 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...
Effects of heparin, venous strangulation obstruction of the small intestine, and reperfusion of the small intestine on plasma diamine oxidase activity in horses. Diamine oxidase (DAO), an enzyme of small intestinal origin, is released from mucosal storage sites by IV administration of heparin, to yield the plasma postheparin DAO (PHD) curve. The PHD curve is diminished when mucosal surface area is lost, and baseline (without heparin) plasma DAO activity increases when mucosal storage sites are damaged. Plasma DAO activity was measured after 2 doses of heparin were administered IV in healthy, conscious horses. In anesthetized horses, the PHD curve was studied: during sham small intestinal surgery, and during venous strangulation obstruction (VSO) of the...
An analysis of 75 cases of intestinal obstruction caused by pedunculated lipomas. A retrospective study of 75 cases of pedunculated lipoma obstruction (PLO) of the intestine was conducted. Age, breed and sex distributions were compared to the non-PLO colic population. Horses in the PLO group were significantly older than in the non-PLO colic group (P < 0.001). A significant increase in risk of PLO was associated with geldings (O.R. 2.32) and with ponies (O.R. 3.75). Of the 75 PLO cases analysed, 69 were strangulating, 70 involved small intestine and 5 involved small colon. Cases of strangulation obstruction tended to have lipomas originating distant to the mesenteric border...
The effects of cisapride on the restoration of gut motility after surgery of the small intestine in horses; a clinical trial. Seventy horses surgically treated for colic caused by disorders of the small intestine were included in a randomized blind trial to determine the effects of cisapride (0.1 mg/kg bw intramuscularly at 8-h intervals) on the post-operative restoration of gut motility. Cisapride appeared to reduce the incidence of post-operative ileus. It accelerated the restoration of bowel motility, reducing the period of post-operative intensive care. It is concluded that cisapride is an effective and useful drug in the post-operative treatment of horses after surgery of the small intestine.
Analysis of hemostasis in horses with colic. Eight tests of hemostasis were measured in 233 horses with colic. Blood samples were obtained at admission and for 4 consecutive days of hospitalization. Data were analyzed retrospectively by outcome, by broad-category diagnosis group, by small intestinal disorder, and by smaller categories for comparing specific diseases. Nonsurviving horses and horses with the most severe forms of intestinal ischemia had changes interpreted as hypercoagulative, the intensity of which was increased on the first and second mornings (sample times 2 and 3) after admission, when most significant differences for r...
Retrospective analysis of the results of 151 exploratory laparotomies in horses with gastrointestinal disease. Of 149 horses that underwent 151 exploratory laparotomies for gastrointestinal disorders from September 1987 to May 1991, 107 (72%) were discharged from the hospital: 100 (66%) survived for > 7 months, 94 of which returned to their intended use. Survival rate (64/80) for horses with caecum/large colon obstruction was significantly (P = 0.003) higher than for horses with small intestinal obstruction (33/64). Prolonged surgery was associated with significantly (P < 0.001) lower survival rates than short surgical time. In the large intestine, survival rate (15/29) for strangulated obstructions wa...
Peritonitis in horses: 67 cases (1985-1990). Peritonitis was diagnosed in 67 horses between 1985 and 1990: 14 horses developed septic peritonitis after intestinal rupture, 25 horses developed peritonitis after abdominal surgery, and 28 horses had peritonitis not associated with intestinal rupture or abdominal surgery. Forty of 67 horses (59.7%) did not survive. Nonsurvivors had higher heart rates (P = 0.01), RBC count (P = 0.039), serum creatinine concentration (P = 0.036), PCV (P = 0.007), and anion gap (P = 0.005); lower venous blood pH (P = 0.002); and a greater number of bacterial species cultured from peritoneal fluid samples (P = 0...
Segmental ischemic necrosis of the small intestine in two postparturient mares. Two mares developed segmental ischemic necrosis of the small intestine after parturition. In one mare, the mesentery of the small intestine apparently tore during parturition, after which necrosis developed in a 52-cm segment of the distal portion of jejunum. In the other mare, a 52-cm segment of the proximal portion of ileum tore during parturition. Three weeks later, a 40-cm segment of the distal portion of jejunum became incarcerated in the mesenteric rent and twisted 360 degrees on its mesentery. Both mares recovered after resection of affected intestine and are functioning as broodmares.
Small intestinal incarceration through the lateral ligament of the urinary bladder in a horse. Small intestinal incarceration through the lateral ligament of the urinary bladder was diagnosed in a 14-year-old, 569-kg, castrated Quarter Horse. The incarceration was corrected by ventral midline celiotomy. Approximately 70 cm of the middle portion of the jejunum was resected and end-to-end, single-layer anastomosis was performed. After surgery, the horse developed signs of adynamic ileus and lameness in the right forelimb. The horse developed laminitis in all 4 feet within 24 hours of surgery. The horse was euthanatized because of poor prognosis for survival. At necropsy, a 4.5-cm rent was...
Obstructive enterolith in an 11-month-old miniature horse. An obstructive enterolith was diagnosed in an 11-month-old 68-kg miniature horse with a 24-hour history of mild, intermittent colic. Abdominal radiography revealed gas distention of the cecum and the right and left ascending colon, and a radiodense elliptical structure in the area of the left kidney. During exploratory laparotomy, the right dorsal colon was noticed to contain ecchymotic hemorrhage and generalized discoloration in the portion proximal to the location of the enterolith. While exteriorizing the ascending colon, it ruptured caudal to the diaphragmatic flexure in the right dorsal c...
Pedunculated lipomas as a cause of intestinal obstruction in horses: 17 cases (1983-1990). The medical records of 17 horses that were evaluated and treated because of colic caused by pedunculated lipomas between 1983 and 1990 were reviewed. The mean age of the horses was 16.6 +/- 3.9 years (range, 10 to 26 years), which was significantly greater than that of the population of horses evaluated because of colic (control population) during the same period. There were significantly more geldings (76.5%), compared with the control population. Nasogastric reflux ranged from 1 to 16 L in 8 horses and was not obtained in 9 horses. Abdominal palpation per rectum revealed small intestinal dis...
Idiopathic muscular hypertrophy of the equine small intestine: 11 cases (1980-1991). The medical records of 11 horses with idiopathic muscular hypertrophy (MH) of the small intestine were reviewed to determine the clinical and pathological features of the disease. The median age of affected horses was 10.0 years (range 5-18 years). No breed or sex predisposition was apparent. Ten horses (91%) had chronic (23 days to 2.4 years) signs of mild, intermittent colic, and 1 horse had signs of severe colic of only 3 days' duration. Partial anorexia and chronic weight loss of variable duration (1-6 months) were prominent historical findings in 5 (45%) horses. Diagnostic tests, with the...
Surgical treatment of colic in American miniature horses: 15 cases (1980-1987). A study of 15 American miniature horses (AMH) that underwent surgical treatment for colic was performed. Information obtained from the medical records included signalment, clinical signs, type and location of gastrointestinal lesion, and postoperative complications. All 15 AMH had intraluminal obstructions, attributable to feed impactions (11 horses), enteroliths (2), and sand (2). The most common location of obstruction was the small colon, which was involved in 9 of the 15 cases. All 15 AMH survived and were discharged from the hospital. Six of the 15 AMH underwent subsequent surgical treatm...
Ileocecal intussusception corrected by resection within the cecum in two horses. Irreducible ileocecal intussusceptions pose a difficult surgical problem. Strangulating ileocecal intussusceptions involving the ileum and jejunum were identified in 2 horses undergoing exploratory laparotomy because of colic. Surgical correction in both horses was achieved by amputation of the ileocecal intussusception from within the cecal lumen, via typhlotomy. The inverted ileal stump was blindly stapled near the ileocecal orifice after pulling the intussusceptum into the cecum. A jejunocecostomy was performed to reestablish intestinal continuity.
Intestinal myxosarcoma in a thoroughbred mare. A large fibrotic mass originating from the cecal base was discovered upon surgical exploration of the abdomen in a Thoroughbred mare with a history of chronic colic and weight loss. The mass protruded intraluminally resulting in partial obstruction. Surgical excision was not feasible due to the location of the mass and the inability to exteriorize it adequately from the abdominal cavity. The mass was fibrous with a shiny, gelatinous material present throughout the neoplasm. Histologically, large confluent spaces filled with mucopolysaccharides were identified by staining with Alcian blue. The ...
Ileal intussusception in 16 young thoroughbreds. The paper describes the outcome of 16 cases of short-ileal-ileal intussusception in young Thoroughbred horses. The intussusception was often associated with chronic or intermittent low grade abdominal pain. At laparotomy, only the intussusception was reduced in one horse; in another, a myotomy of the thickened stenosed intussusception was carried out after reduction. In 11 cases as ileocaecal bypass anastomosis was performed proximal to the intussusception after its reduction. One horse was subjected to euthanasia during operation because of irreversible intestinal wall damage and another beca...
Evaluation of peritoneal fluid following intestinal resection and anastomosis in horses. 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,...
Resection and anastomosis of the small colon in four horses. Resection and anastomosis of the small colon was performed on 4 horses with vascular lesions (strangulating lipoma, mesenteric tear, dissecting haematoma) or functional obstruction (stricture) of this area of the bowel. The anastomoses were performed using a variety of suture materials in 2 layers. An appositional, full-thickness, simple, interrupted pattern was used in the first layer in all cases and oversewn with either a Cushing pattern (3 cases) or a Utrecht pattern (1 case). Post-operative complications associated with suture material and surgical technique were not seen. All horses were...
Sutured end-to-end and stapled side-to-side jejunal anastomoses in the horse. Hand sutured end-to-end (EE) and stapled side-to-side (SS) small intestinal anastomoses were performed in 10 healthy adult horses. In five SS anastomoses, staple lines on the blind ends of the jejunum were inverted (SSI) and in five they were not (SSNI). Five EE anastomoses were sutured with polydioxanone and five were sutured with polyglyconate. All horses were euthanatized on day 30. Intra-abdominal adhesions were graded (0-4), and stomal areas were calculated from contrast radiographs made with the bowel distended. Histopathology scores for the anastomoses were based on the degree of inflam...
Xanthine oxidase formation during experimental ischemia of the equine small intestine. We hypothesized that xanthine oxidase plays a role in the postischemic reperfusion injury in the equine small intestine. Under anesthesia, four horses and two ponies underwent ischemic strangulating obstructions of segments of the proximal jejunum, mid-jejunum and ileum. Prior to vascular occlusion, and at 1 h and 2 h of ischemia, full-thickness intestinal biopsies were collected for histopathological evaluation and for determination of combined xanthine dehydrogenase (XDH) plus xanthine oxidase (XO) activity, and XO activity alone. The level of XO activity was expressed in percentage accordin...
Serum levels of type III procollagen peptide in Equidae before and after intestinal ischemia. 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...
Surgical correction of strictures of the large colon in three horses. 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.
A comparison of three techniques for closure of pelvic flexure enterotomies in normal equine colon. Six enterotomies 3 cm long, spaced at 3 cm intervals, were made in the antimesenteric border of the pelvic flexure of the ascending colon in five adult horses. Ten incisions each were sutured with a Utrecht pattern (single layer), a full-thickness simple continuous oversewn with a Cushing pattern (two layer), and a mucosal simple continuous with a seromuscular simple continuous oversewn with a Cushing pattern (three layer). In all horses, chromic gut and polyglactin 910 were each used once for each pattern. On day 6, the pelvic flexure was excised and the colonic vessels were injected with a r...
Steady-state response characteristics of a pulse oximeter on equine intestine. The steady-state response characteristics of a pulse oximeter were evaluated on intestinal segments of seven clinically normal halothane-anesthetized horses. Arterial oxygen tension greater than 200 mm of Hg, end tidal carbon dioxide from 30 to 35 mm of Hg, and systemic mean arterial pressure greater than 70 mm of Hg were maintained throughout the recording periods. Values for percentage of pulse oximeter oxygen saturation, pulsatile blood flow, and percentage of signal strength were recorded from jejunum, ileum, cecum, left ventral colon, left dorsal colon, and descending colon. Probe placeme...
