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.
Evaluation of three techniques for end-to end anastomosis of the small colon in horses. 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...
Comparison of clinical judgment, Doppler ultrasound, and fluorescein fluorescence as methods for predicting intestinal viability in the pony. Strangulation obstruction was induced in anesthetized ponies for periods of 2 and 3 hours by clamping 45-cm segments of jejunum and associated veins (venous strangulation obstruction) and arteries and veins (arterial and venous strangulation obstruction). Four segments were studied in each of 7 ponies allowed to survive 12 hours, 2 segments in a pony that was allowed to survive 1 hour, and 1 segment in each of 10 ponies allowed to survive 42 days after the strangulation periods ended. Fifteen minutes after the periods of strangulation obstruction ended, the viability of test segments was asses...
Early mucosal healing and chronic changes in pony jejunum after various types of strangulation obstruction. Strangulation obstruction was induced in anesthetized ponies for periods of 2 and 3 hours by clamping 45-cm segments of jejunum and their veins only (venous strangulation obstruction, VSO) and arteries and veins (arterial and venous strangulation obstruction, AVSO). These types of strangulation obstruction were studied in 4 segments in each of 4 ponies allowed to survive 12 hours (group 1) and in a single segment in each of 10 ponies allowed to survive 42 days (group 2) after the strangulation period ended. On visual inspection, segments subjected to VSO had hemorrhage and edema in the bowel w...
Surgical treatment of acquired inguinal hernia in the horse: a review of 51 cases. 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 ...
Incarceration of the small intestine by the epiploic foramen in fifteen horses. In 15 horses with acute abdominal disease, a diagnosis of incarceration of small intestine through the epiploic foramen was made, either at the time of exploratory celiotomy or at necropsy.The horses exhibited signs of moderate to severe abdominal pain and were suffering from hypovolaemic and/or endotoxic shock. Nasogastric intubation produced either gas or fluid, the pH of which was in the range of 5 to 7.2, indicating reflux of small intestinal content into the stomach. Consistent physical findings included absence of gut sounds on auscultation, dilated small intestine palpable on rectal exa...
Complications of umbilical hernias in horses: 13 cases (1972-1986). Of 147 horses treated for umbilical hernias over a 13.5-year period, 13 horses (8.8%) developed complications in association with umbilical defects. Six horses had intestinal incarceration; the incarceration was reduced manually in 3 horses before admission, resolved without treatment in 2 others, and was surgically reduced in one. Herniorrhaphy was performed on 4 of the 5 horses in which the incarceration did not require surgical reduction, and the fifth was managed conservatively. A horse with a parietal hernia and a horse with intestinal stragulation were treated surgically; in the latter, ...
Bypass surgery for the treatment of small intestinal ileus in the horse. A report of three cases. 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...
Morphologic effects of experimental distention of equine small intestine. The morphologic effects of induced intraluminal hydrostatic pressures (IHPs) of 0, 9, and 18 cm H2O were evaluated in 33 isolated equine jejunal segments. Fifteen segments were distended with Tyrode's solution for 1 hour and nine segments for 4 hours. Tyrode's solution was added as needed to maintain the prescribed pressures. Nine other segments were left undisturbed for 4 hours after the initial distention period. On decompression of the intestinal segments, progressive peristaltic contractions resumed in all segments. Evaluation of intestinal sections by light microscopy and transmission ele...
Small intestinal adenocarcinoma in a horse. A 21-year-old mare was evaluated for intermittent episodes of apparent abdominal pain of 6 month's duration. Abdominal palpation per rectum revealed distended small intestine in the caudal portion of the abdomen. Ventral midline celiotomy revealed a mass in the midjejunal region. The mass was resected, and a side-to-side anastomosis performed. The histologic diagnosis was tubular adenocarcinoma of the small intestine. The mare was still alive 13 months after surgery.
Elective inversion of the distal ileal stump into the caecum of the horse. The distal 30 to 40 cm of the ileum cannot be exteriorized through a midline laparotomy incision because of its close anatomical association with the base of the caecum. A method was developed to deal with those cases where this segment of small intestine was involved in an avascular, necrotic process and therefore required resection. The technique involves inverting the distal stump of ileum into the lumen of the caecum and then performing a routine ileocaecal or jejunocaecal anastomosis. This avoids the risk of peritonitis if a Parker-Kerr oversew of the necrotic ileal stump should dehisce. ...
A potential technique error in stapled side-to-side anastomosis of the small intestine of the horse. 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...
Chronic nongranulomatous enteritis in seven horses. 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.
The use of staplers in equine intestinal surgery. Automatic suturing instruments were tested in two ponies and two horses. The TA stapler was used for bowel closure (enterotomies and gut transection) and for end-to-end 'triangulation' anastomoses. The GIA stapler was used for making side-to-side anastomoses. In one horse several enterotomies were made at different stages and the results of suturing by hand and with a stapler were compared. The utility of both types of staplers is discussed in relation to clinical evaluations and macroscopical and microscopical findings post mortem.
Ileocecocolic intussusception as a sequel to jejunocecostomy in a mare. An excessively long ileal stump, the result of a previous jejunocecostomy, had intussuscepted into the cecum and subsequently obstructed the cecocolic orifice of a 12-year-old Quarter Horse mare. Clinical signs were dehydration, ileus, and endotoxemia. The diagnosis was made at necropsy.
Hemorrhagic fibrinonecrotic duodenitis-proximal jejunitis in horses: 20 cases (1977-1984). Records of 20 horses with small intestinal disease causing acute colic and affecting the proximal portion of the small intestine were examined retrospectively. The disease was characterized by severe to moderate pain, which was replaced by depression, fever, gastric reflux, slight distention of the affected small intestine, leukocytosis, and high concentrations of total protein in the peritoneal fluid. Grossly, the affected intestines were hemorrhagic and had yellow discoloration. Histopathologic findings included submucosal edema, neutrophilic infiltration of the submucosal and laminal propri...
Extensive large colon resection in the pony. I. Surgical procedures and clinical results. The effect of resection of 75% (length measurement) of the large colon in ponies was studied. Ten ponies in good physical condition were divided into two groups: group I consisted of the six experimental ponies and group II of four control ponies. Preoperatively and postoperatively for five months, ten clinicopathological parameters were determined: body weight, venous blood pH, plasma bicarbonate, total plasma protein concentration, serum electrolyte values (sodium, potassium, chloride), and fecal osmolarity. Subjective assessment of attitude and appetite revealed no difference between the gr...
[Effect of ascorbic acid on the intestinal motor activity in domestic animals]. 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...
Surface oximetry of healthy and ischemic equine intestine. Measurements of jejunal, ileal, and large colon (pelvic flexure) surface O2 tension (PSO2) were made in halothane-anesthetized horses with a nonheated miniature oxygen polarographic electrode. Assisted ventilation with 100% O2 was used to maintain PaCO2 tension at 50 +/- 8 mm of Hg while mean arterial blood pressure was maintained greater than or equal to 70 mm of Hg. Mean +/- SD PSO2 for the intestinal segments were: jejunum (horses 1 to 4), 71 +/- 20 mm of Hg; ileum (horses 1 to 4), 61 +/- 8 mm of Hg; and pelvic flexure of the large colon (horses 1 to 10), 55 +/- 13 mm of Hg. The response of...
Surgical management of intussusception in the horse. During a 14 year period, 27 of 310 horses undergoing laparotomy because of abdominal pain were found to have an intussusception involving the small intestine (16 cases) or caecum (11 cases). The clinical signs, operative findings and techniques adopted to overcome the obstruction are described. An evaluation of possible predisposing factors provided further evidence of the important role of the tapeworm Anoplocephala perfoliata in initiating intussusception involving the ileum and caecum.
Colic in two horses associated with smooth muscle intestinal tumours. The research article discusses a rare case of colic in two horses, which was attributed to the existence of smooth muscle intestinal tumors. Introduction The article begins by explaining that […]
Resection and anastomosis of small intestine: current methods applicable to the horse. Intraoperative techniques for assessing the viability of ischaemic bowel are discussed. Intravenous administration of sodium fluorescein appears useful but further investigation of the method is required. Methods of resection and anastomosis of small intestine are described and illustrated, including the use of automatic stapling instruments.
Intestinal atresia and stenosis: a review comparing its morphology. A review of the literature on intestinal atresia of domestic animal species and humans was done. The 5 types of intestinal occlusions described in human infants are atresia type 1, atresia type 2, atresia type 3, stenosis, and the "apple peel" or "Christmas tree" deformity. The intestinal defects described in domestic animal species such as the bovine, equine and porcine are similar to those of human infants. The "T-formation", an intestinal defect of the bovine resembling atresia type 3, and rectal stricture, an acquired intestinal defect of the porcine resembling stenosis, were described rec...
Comparison of suture materials and suture patterns for inverting intestinal anastomosis of the jejunum in the horse. In 7 horses, 4 anastomoses were done in the small intestine in each, using the combinations of synthetic absorbable monofilament and multifilament suture materials with continuous- and interrupted-suture patterns in the serosubmucosal layer of a 2-layer inverting-suture technique. Horses were evaluated 30 days after the operation for adhesion formation, lumen diameter, evidence of chronic obstruction, and suture tract inflammation at the anastomosis. Postoperative obstruction occurred in 5 of the 7 horses, and 6 horses survived. One horse was euthanatized on postoperative day 6 after 48 hours ...
Intestinal decompression: preliminary study in the horse. A technique of nasoduodenal (N-D) intubation and intestinal decompression was developed and used in the horse to explore the prevention of gastric and intestinal distention after abdominal surgical operation. Three styles of tubes (2 single-lumen tubes and 1 double-lumen tube) were positioned in the duodenum of 12 mature horses (10 experimental and 2 clinical) during laparotomy (without enterotomy), and an iatrogenic occlusion at the small intestine was created and later released in the 10 experimental horses. The 2 clinical horses had an exploratory laparotomy to correct a natural obstruction...
Comparison of three suture techniques for anastomosis of the small intestine in the horse. Seven horses were used to compare the Gambee, the crushing, and a 2-layer inverting suture pattern composed of a simple continuous layer in the mucosa oversewn with a continuous Lembert pattern in the seromuscular layer. Horses were evaluated at 30 days for adhesion formation, lumen diameter, and quality of healing at the anastomotic sites. One horse was euthanatized 9 days after surgery after 24 hours of ileus and colic; necropsy revealed septic peritonitis and widespread adhesions. One horse had no adhesions. The remaining horses had adhesions associated with 50% of the Gambee and 50% of the...
Pathologic changes associated with induced small intestinal strangulation obstruction and nonstrangulating infarction in horses. Arteriovenous (ischemic strangulation obstruction, ISO) or venous (hemorrhagic strangulation obstruction, HSO) occlusions were created in the jejunum of 5 anesthetized horses and were left in situ for 1-, 2-, or 3-hour intervals. Segments were evaluated grossly for color, thickness, and motility. The horses were euthanatized, and the degree of mucosal slough, edema, congestion, and hemorrhage was determined histologically. Segments subjected to ISO became dark, but did not contain edema or hemorrhage. Segments subjected to HSO were characterized by progressive congestion, edema, and hemorrhage...
Chronic intestinal intussusception in two horses. In 2 cases of chronic intestinal intussusception in horses, one involved jejunum and the other, ileum. The only clinical signs observed were intermittent colic. Surgery was performed on both horses, with successful outcomes.
Evaluation of fluorescein dye as an indicator of small intestinal viability in the horse. In 6 horses, 2 types of ischemic lesions were created in small intestinal segments by selective ligation of vessels and intestinal wall for 1, 2, or 3 hours. After confirming the ischemia by IV injection of sodium fluorescein, the ligatures were released. Five minutes later, the fluorescent patterns were documented photographically. Observed patterns ranged from normal (identical to that observed in unaffected bowel) to a patchy distribution of non-fluorescence (indicating incomplete perfusion). None of the experimental segments was normal when reevaluated 1 month later. The typical appearance...
Gastric retention associated with a pyloric mass in two horses. Partial pyloric obstruction causing gastric retention is described in 2 young female horses. Gastric retention was confirmed by contrast radiography of the upper gastrointestinal tract. In both horses a large mass was palpated in the wall of the pyloric antrum at exploratory laparotomy. Post-mortem examination of the first case confirmed that this mass was associated with chronic gastric ulceration. Gastric ulceration was not confirmed in the second case but this horse recovered after the pylorus and duodenum were bypassed by gastro-jejunostomy.