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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.
Modification of the cutting thread technique for intestinal anastomoses using diathermy. 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...
Cecocolic intussusception in horses: 11 cases (1979-1989). Over a 10-year period, cecocolic intussusception was diagnosed in 11 of 842 horses undergoing surgical treatment for colic at the New York State College of Veterinary Medicine. Eight horses died or were euthanatized because of poor prognosis determined at surgery or because of postoperative complications. Three horses recovered without complication after manual reduction of the intussusception and partial typhlectomy, using an intestinal stapling device.
Alteration in intestinal morphologic features associated with extensive large-colon resection in horses. 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...
Alteration of intestinal enzyme activities associated with extensive large-colon resection in horses. 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...
Effect of intestinal resection on two juvenile horses with granulomatous enteritis. Two horses were presented with lethargy, weight loss, anorexia, and swelling of the limbs and ventral body wall. One horse, a 12-month-old American Paso Fino colt, also had acute abdominal pain. The other horse, a seven-month-old Tennessee Walking Horse (TWH) filly passed diarrheic stools during the initial examination. Each horse had low serum protein, neutropenia, and a normal packed cell volume (3.2 g/dl, 1300 cells/ul, and 38%, respectively, for the colt, and 2.4 g/dl, 696 cells/ul, and 44%, respectively for the filly). After intravenously administering plasma, the colt's PCV dropped to 23...
Enteric pythiosis in a horse. Enteric pythiosis was diagnosed in a 2-year-old Quarter Horse gelding. The horse had signs of colic, which appeared to be alleviated by administration of mineral oil and analgesics, but only temporarily. Intestinal distention developed after initial examination. At surgery, a thick stenotic area was observed in the middle portion of the jejunum. The thick intestine and associated mesentery contained multiple firm nodules of gritty caseous material. Histopathologic findings included sclerosing eosinophilic granulomatous enteritis and peritonitis. Although the lesion resembled a response to migr...
Retrospective evaluation of repeat celiotomy in 53 horses with acute gastrointestinal disease. Fifty-three of 648 horses (8.2%) treated surgically for acute gastrointestinal obstruction were subjected to repeat celiotomy. Forty horses (75%) recovered from anesthesia after repeat celiotomy, and 26 horses (49%) were discharged from the clinic. Excluding two horses lost to follow-up, 10 of 51 horses (20%) survived long term. Horses subjected to repeat celiotomy had a significantly lower long-term survival rate than horses subjected to a single celiotomy. Twenty-eight horses had mechanical obstructions, and 22 had functional obstructions at the second surgery. Significantly more horses with...
Survival after small intestine resection and anastomosis in horses. The authors examined factors influencing survival in 140 horses that recovered from anesthesia after small intestinal resection between 1968 and 1986, using Kaplan-Meier estimated survival curves and the Cox proportional hazards regression model. Seventy-two horses (51%) died during the initial postoperative period, 19 horses (14%) died after discharge from the hospital, 33 horses (24%) were alive, and 16 horses (11%) were classified as censored. Mean age at surgery was 8 years. Horses 15 years of age or older, Arabians and Stallions, were overrepresented in the hospital population. The most c...
Induction of peritoneal adhesions with small intestinal ischaemia and distention in the foal. Twenty-two foals were divided into groups of intestinal distension and intestinal ischaemia as methods to induce peritoneal adhesions. In the first group, the lumen of a segment of distal small intestine was occluded without extramural vascular compromise and distended with lactated Ringer's solution to a constant pressure of 25 cm H2O for 2 h within the abdomen. The ischaemic group underwent 70 mins total vascular occlusion of identical segments of bowel. Serosal biopsies were obtained before and after each experimental procedure and following 60 mins of reperfusion. Similar biopsies were har...
Chronic ileocecal intussusception in horses. 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...
Large intestinal capacity, retention times, and turnover rates of particulate ingesta associated with extensive large-colon resection in horses. 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...
Determination of intestinal viability. Operations for intestinal ischemia are frequently done by veterinarians. In equine surgery those conditions commonly producing ischemia are intussusception, volvulus, bowel obstructions, and incarcerated hernias. In an attempt to predict intraoperative bowel viability after the restoration of circulation, a variety of adjuvant methods have been investigated. There is little question that of the techniques currently available, sodium fluorescein injected intravenously approaches the ideal in predicting nonviability in humans and in most animal models. Furthermore, it is safe, takes little opera...
Prevention of large colon displacements and volvulus. Results of these studies have demonstrated that colopexy of the left large colon to the abdominal wall is a relatively simple and quick procedure that is permanent 1 year after surgery. The technique does not appear to be associated with long-term weight loss or abdominal pain after surgery. It has been used in pregnant mares, both experimentally and clinically, without apparent complications. In addition, horses used for pleasure-riding and show hunting have returned to performance and have not had complications. Large colon resection is a useful technique, especially for animals with strangu...
Intestinal healing and methods of anastomosis. Optimal intestinal healing occurs when like layers of the intestinal wall are aligned. Hand-sewn, double-layer, end-to-end anastomosis that apposes the mucosa and produces slight inversion of the seromuscular layer is recommended to minimize adhesion formation and provide reasonable alignment of the intestinal layers. Stapled, everted, triangulated, end-to-end anastomosis is not recommended because of extensive adhesion formation and poor healing of the intestinal layers. The preferred stapled techniques create an inverting, side-to-side stoma between the bowel segments.
Large colon resection. With large colon resection and anastomosis, up to 95 per cent of the length of the large colon has been successfully removed. A hand-sewn end-to-end anastomosis is effective for lesions in the left dorsal colon and pelvic flexure. Transection and a side-to-side anastomosis with stapling equipment is most effective for extensive resections (greater than 50 per cent). Horses with extensive colon resection (95 per cent) have permanent deficiencies of water absorption and digestion of cellulose and protein. Fermentative capacity is reduced, owing to decreased particulate matter retention time in t...
The pathophysiology of intestinal damage: effects of luminal distention and ischemia. Intestinal edema, luminal distention, and ischemia are common pathologic processes involved in producing the intestinal damage found during surgical exploration for acute abdominal disorders in the horse. The severity of intestinal edema depends on the degree of altered intravascular forces and changes in capillary permeability. Capillary hydrostatic pressure rises as the less pliable venules and veins become occluded during intestinal obstruction. Concurrently, the production of various endogenous products that damage the vascular wall leads to increases in capillary permeability and protein ...
Use of a linear stapling device to construct an inverted, triangulated, end-to-end anastomosis of the equine jejunum. 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...
Correlative morphometry and morphology of normal equine intestinal mucosa and comparison after adaptation to extensive large colon resection. Light microscopy, morphometry and scanning electron microscopy (SEM) were used to examine the mucosal morphology of seven intestinal specimens (three from the small intestine and four from the large intestine) from two horses not subjected to surgery and three horses one year after sham-operation for colon resection. Qualitative and quantitative evaluation revealed similar morphology for all horses except that the unoperated horses had significantly (P < 0.05) fewer goblet cells in the crypts of the large intestine. In the small intestine, SEM demonstrated that villus shape varied and range...
The effect of low dose heparin therapy on complication and survival rates in horses following exploratory celiotomy. A randomised, blind prospective study was performed to evaluate effects of low dose heparin therapy on complication and survival rates in 33 horses following exploratory celiotomy. Four horses had non-strangulating lesions and seven had strangulating lesions of the small intestine, 19 had non-strangulating lesions of the large intestine, and three had duodenitis-proximal jejunitis. Eighteen required an enterotomy or intestinal resection and anastomosis. Sixteen received heparin subcutaneously (66 iu/kg every 12 h) post operatively and 17 received a saline placebo for a mean of 3.7 days. There ...
Ganglioneuroma as a cause of small intestinal obstruction in the horse: a case report. The clinical signs, medical and surgical management, and pathological findings are described for a ganglioneuroma, an atypical intestinal tumor, that caused colic because of small intestinal obturation.
Small intestinal strangulation caused by Meckel’s diverticulum in a horse. Necropsy of a 12-year-old Quarter Horse mare revealed a blind-end segment of intestine originating from the antimesenteric border of the ileum. The blind-end segment had looped around and strangulated the ileum and 3.5 m of the jejunum.
Enterotomy technique in the descending colon of the horse. Effect of location and suture pattern. To compare the effects of placing enterotomy incisions on or off the antimesenteric teniae and closing the intestinal mucosa as a separate layer, four longitudinal enterotomies were performed in the descending colon of each of six horses by the following techniques: incision through the antimesenteric teniae with one- and two-layer closure, and incision adjacent to the teniae with one- and two-layer closure. The horses were necropsied at day 33 for evidence of obstruction, adhesions, and ultrasonographic determination of the percent reduction in lumen diameter. Histologic and histomorphometric...
Ultrasonographic diagnosis of small-intestinal intussusception in three foals. Small-intestinal intussusceptions were diagnosed in 3 foals. Cross-sectional ultrasonography through the apex of the intussusceptum revealed a target-like pattern with a thick hypoechoic rim. The thick hypoechoic rim was caused by severe edema of the entering and returning walls of the intussusceptum. At the more proximal portion of the intestines, where parietal edema was less severe, the image appeared as 2 concentric rings and an inner circular area. The outer ring and inner circular area were hypoechoic and represented the returning and the entering wall of the intussusceptum. An additiona...
Caecal intussusceptions in horses and the significance of Anoplocephala perfoliata. A caecocaecal intussusception in a pony and a caecocolic intussusception in a horse, both infected with Anoplocephala perfoliata, are described and the relevance of tapeworms in such intestinal disease of horses is reviewed.
Evaluation of two techniques for large intestinal resection and anastomosis in the horse. 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...
Surgical treatment of sand colic in equids: 48 cases (1978-1985). Medical records of 48 equids (47 horses, 1 pony) with surgical sand colic were reviewed. The diagnosis of sand colic was made if a sand impaction(s) was palpated during exploratory abdominal surgery or if a large quantity of sand was found during colotomy. Most equids did not experience a previous episode of sand diarrhea or sand colic. Clinical findings and results of clinicopathologic determinations were not diagnostic. Rectal palpation findings in 40 of 46 horses were compatible with large-colon and/or cecal distention. Impactions were palpable per rectum in only 7 horses, but emergency abd...
A comparison of enterotomies through the antimesenteric band and the sacculation of the small (descending) colon of ponies. Three pairs of longitudinal enterotomies were performed in the small colon of 10 ponies. Each pair consisted of one enterotomy through the antimesenteric band and one through the sacculation. The ponies were destroyed 96 h after surgery. The enterotomies in the two sites were compared for: speed of surgery, adhesions, bursting wall tension, neovascularisation by micro-angiography, and histological reaction. Enterotomies made through the antimesenteric band were superior because they were quicker to perform, stronger, more accurately apposed, and had less inflammation than those made through th...
