Topic:Laparotomy
Laparotomy in horses refers to a surgical procedure involving an incision into the abdominal cavity. It is performed for diagnostic or therapeutic purposes, such as exploring the abdomen, addressing colic, or removing foreign bodies. The procedure requires general anesthesia and is typically conducted in a sterile surgical environment. Post-operative care is critical to ensure proper healing and to monitor for potential complications, such as infection or adhesions. This page compiles peer-reviewed research studies and scholarly articles that explore the techniques, outcomes, and post-operative management associated with laparotomy in equine patients.
Standing laparoscopic laser technique for ovariectomy in five mares. Laparoscopic laser instrumentation and endoscopic stapling techniques were used to perform 10 unilateral ovariectomy procedures on 5 standing Thoroughbred mares. In all instances, mares had a clinically normal reproductive tract and estrous cycle, and ovariectomy was performed to eliminate regular estrous behavior. All procedures were accompanied by minimal trauma and uncomplicated postoperative recovery. Mares were able to resume normal activity 2 weeks after surgery. Regular estrous behavior was eliminated in all 5 mares, although 1 mare continued to have signs of estrous behavior occasional...
Paravertebral thoracolumbar anaesthesia in 10 horses. The caudal border of the last rib was used as a reliable point of orientation while performing paravertebral thoracolumbar anaesthesia (PTLA) on 10 horses undergoing standing flank laparotomy. The local anaesthetic in all horses was 2% lidocaine. The PTLA procedure was completed in 9.8 +/- 1.8 mins (mean +/- sd). Sedation was provided by a combination of intravenous morphine with xylazine or detomidine. Overall analgesia, provided by the combination of PTLA and sedation, was rated as excellent in 2 horses and good in 6 horses. In the remaining 2 horses, overall analgesia was rated as fair beca...
Effect of surgical removal of endometrial cups on concentrations of chorionic gonadotrophin and subsequent fertility in the mare. Seven pregnant mares underwent general anaesthesia, laparotomy, hysterotomy and removal of a 50-day conceptus. Eversion of the uterine horn through the hysterotomy site allowed direct visualisation and electrosurgical removal of endometrial cup tissue from 5 randomly selected mares (Nos 1-5), while cup tissue in 2 mares (Nos 6 and 7) was left intact. Two pregnant mares served as unoperated controls (Nos 8 and 9). Efforts to re-establish pregnancy were initiated 20 days after surgery. Serum samples collected before surgery and during the post-operative period were analysed for concentration of ...
The effect of exploratory laparotomy on the serum and peritoneal haptoglobin concentrations of the pony. Serum haptoglobin concentration was used as an indicator of the acute phase response in ponies undergoing exploratory laparotomy. Preoperative, 1 h intraoperative, 3 h, 6 h, 12 h and 24 h postoperative blood samples and 48 h postoperative peritoneal fluid samples were obtained for haptoglobin analysis. A spectrophotometric assay based on cyanmethemoglobin binding capacity (CyanBC) was used to determine haptoglobin concentrations. The preoperative reference range for serum haptoglobin concentrations in these ponies was 25-60 mg CyanBC/dL. Intraoperative and 3 h postoperative blood samples had d...
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...
[2 cases of ‘hardware’ foreign objects in ponies]. An obstruction of the small intestine was suspected in two ponies with colic. At surgery and at necropsy, the cause of the colic appeared to be an inflammation process caused by perforation of the jejunum by a piece of wire. One pony recovered after laparotomy and enterectomy, but had to be put down eight weeks later because of severe laminitis. The other pony was euthanized immediately after clinical evaluation.
Uterine torsion and uterine tear in a mare. A 15-year-old Standard-bred mare was examined because of signs of abdominal discomfort in late gestation. Palpation per rectum revealed tight broad ligaments above and below the uterus, with the right broad ligament running across the top of the uterine body down toward the left, ventral side of the abdomen. A diagnosis of counterclockwise uterine torsion was made and surgical correction was approached via a left, flank laparotomy with the horse standing. The uterus was repositioned and a uterine tear encompassing 180 degrees of the uterine surface was found in the lateral, uterine body just c...
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.
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...
Anesthetic management of an incisional dehiscence in recovery following exploratory laparotomy in a horse. A 5-year old Arabian mare fell during recovery from general anesthesia after an exploratory laparotomy. This fall resulted in dehiscence of the abdominal closure, and a substantial amount of intestines were exteriorized. Chemical and manual restraints were rapidly used to prevent trauma to the exposed intestines. A second general anesthesia was initiated to clean the intestines and close the incision. Multiple anesthetic problems were encountered, including arterial hypotension and hypoxemia. The horse recovered from the second general anesthesia and surgery, and all complications gradually re...
Volvulus of the colon in a horse associated with a mesocolic-umbilical band. A 7-years-old Clydesdale mare was presented with severe abdominal distension and acute colic. Dilated large intestine was palpated per rectum and a ventral midline exploratory laparotomy was performed. A 180 degrees volvulus of the pelvic flexure was present, associated with an inelastic band of tissue connecting the mesocolon to the umbilicus. The band was ligated and transected, and the volvulus reduced. Postoperative complications included hyponatraemia, metabolic acidosis and laminitis. The possible aetiology of the mesocolic-umbilical band is discussed.
[Stomach ulcers in the horse–clinical and gastroscopic findings in 12 horses (1989-1990)]. Twelve horses with clinical symptoms of a gastric disorder were studied by gastroscopy. Symptoms of gastric disorders were periprandial colic, bruxism, ructus and reflux. Preliminary to gastroscopy the horses were fasted for 24 h. Access to water was not restricted. The gastroscopy could be conducted easily using a fiberscope 2.5 m in length and 11 mm in outer diameter. While ulcers were present in the squamous fundus of all horses only one horse showed ulceration of the glandular fundus. Solitary ulcers near the margo plicatus were found in horses with mild clinical symptoms. In contrast, dif...
Effects of exploratory laparotomy on plasma and peritoneal coagulation/fibrinolysis in horses. Plasma and peritoneal fluid samples were collected before and after surgery from 6 horses undergoing a ventral midline exploratory laparotomy and from 6 anesthetized control horses. Coagulation/fibrinolytic components measured in the plasma and peritoneal fluid of these horses included the functional activity of antithrombin III, alpha-2 antiplasmin, plasminogen, and protein C, and the concentrations of fibrinogen and fibrin degradation products. Peritoneal fluid antithrombin III, fibrin degradation products, and plasminogen values were significantly increased after surgery (over time) in prin...
Ileal diverticulum as a cause of chronic colic in a horse. A 4-year-old Thoroughbred gelding with a history of chronic colic was referred for evaluation of signs of abdominal pain. Exploratory laparotomy revealed a diverticulum of the distal portion of the ileum located between the layers of the mesentery. The diverticulum was similar in location and appearance to acquired ileal diverticula described in human beings. Complete bypass of the diverticulum by ileocecostomy resulted in apparent resolution of the chronic colic in this horse.
Severe hypercarbia resulting from inspiratory valve malfunction in two anesthetized horses. Severe hypercarbia was documented by arterial blood gas analysis in 2 adult horses anesthetized for exploratory laparotomy. Both horses appeared to be adequately anesthetized, but continued to breathe against the ventilator. In both cases, the inspiratory valve on the anesthesia machine was found to be stuck open, permitting expired CO2 to return to the inspiratory limb of the anesthetic circuit and to be inhaled with the next breath. Correction of the malfunctioning valve alleviated the hypercarbia. Problems with the flow valves of the anesthesia machine should be suspected when anesthetized ...
Peritonitis in adult horses: a review of 21 cases. The clinical signs in 21 adult horses affected by peritonitis (unassociated with gastrointestinal rupture or surgical interference of the abdomen) included colic (18 cases), pyrexia (15 cases), weight loss (six cases) and diarrhoea (five cases). The diagnosis was based on a nucleated cell count in peritoneal fluid greater than 10(10)/litre. Haematological abnormalities (either neutropenia or neutrophilia) were present in 17 animals, and hyperfibrinogenaemia was identified in 14. Twelve of the 21 horses survived after intensive antibiotic therapy; the other nine were destroyed either at explora...
Further experiences with non-surgical correction of nephrosplenic entrapment of the left colon in the horse. Non-surgical correction of nephrosplenic entrapment of the left colon was attempted in 27 cases. In two cases the method failed and a laparotomy was necessary. Two other horses had a recurrence, one of which underwent laparotomy because of torsion of the caecal body.
Hemoperitoneum caused by rupture of a juvenile granulosa cell tumor in an equine neonate. A neonatal foal was examined because of apparent abdominal pain and distention, anemia, and hemoperitoneum. Exploratory laparotomy was performed, and a large spherical mass, which had ruptured, was found in the area of the left ovary. Left salpingo-oophorectomy was performed. The mass was determined to be a juvenile granulosa cell tumor.
Lymphocytic enteritis in a filly. A yearling Hanoverian filly had intermittent colic for 6 weeks, chylous peritoneal effusion, and a firm mass palpable per rectum. Exploratory laparotomy revealed mesenteric lymphadenopathy, adhesion of the mesenteric root to the duodenum and jejunum, distention of the mesenteric veins and lymphatic vessels, and increased jejunal venous pressure. Lesions in the duodenum, jejunum, and colon included infiltration of lymphocytes and plasma cells in the lamina propria.
Serum and peritoneal fluid phosphate concentrations as predictors of major intestinal injury associated with equine colic. To determine the reliability with which inorganic phosphorus (phosphate) concentrations can be used to predict major intestinal injury associated with equine colic, phosphate concentrations were measured in serum, peritoneal fluid, or both from 9 clinically normal adult horses (group A), 37 horses successfully managed medically for signs of abdominal pain (group B), 26 horses with signs of abdominal pain and undergoing exploratory laparotomy without intestinal resection (group C), and 26 horses undergoing intestinal resection or euthanasia for extensive intestinal lesions (group D). Peritoneal...
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 ...
Correction of bilateral ureteral defects in a foal. Bilateral ureteral defects were diagnosed as the cause of depression and azotemia in an 8-day-old Thoroughbred filly. The azotemia resulted from accumulation of urine in the retroperitoneal area. A ventral midline laparotomy was performed, and defects found in both the left and right ureter were repaired. Uroperitoneum and abdominal distention, presumably from urine leakage at the left ureteral surgery site, were detected on the fourth postoperative day and necessitated abdominal drainage. Thirty-six hours later, the leakage stopped spontaneously, and the foal recovered normally. This report s...
Peritoneal fluid analysis in ponies after abdominal surgery. Ten student surgery ponies were subjected to exploratory laparotomy. Abdominal paracentesis was performed preoperatively and daily postoperatively for 6 days, then the ponies were euthanatized and necropsied. Initial baseline peritoneal fluid parameters were within established reference limits. Postoperatively, the total leukocyte count and total protein in the peritoneal fluid rose and remained elevated for the 6 days of the study. Complete blood counts (CBCs) were performed preoperatively and on days 1 and 4 postoperatively. On day 1, a stress leukogram with a mild inflammatory component dev...
Methods for collecting follicular oocytes from mares. A series of experiments was conducted to develop a procedure for consistent, repeatable collection of oocytes from the preovulatory follicle of the mare. In one experiment, in situ follicular aspiration with a needle and syringe was performed on 19 mares. From 37 aspirations, four oocytes were recovered (10% recovery rate). In a second experiment, ovaries were visualized via standing flank laparotomy during which two different aspiration techniques were used. Use of a needle and syringe as in the first experiment resulted in successful oocyte recovery in one of seven (14%) attempts. Aspiration...
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. ...
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.
Repair of a diaphragmatic hernia in a horse. One month after falling heavily a four-year-old horse developed acute colic while being exercised. A tentative diagnosis of diaphragmatic hernia was reached on the basis of the clinical findings and confirmed at laparotomy. The defect was repaired and the horse made an uneventful recovery.
Splenic hematoma and abscess as a cause of chronic weight loss in a horse. An 8-year-old gelding with a 3-month history of anorexia and weight loss was found to have a massive subcapsular splenic hematoma. At flank laparotomy, 36 L of fluid was removed from the hematoma. The horse's condition improved after drainage. Fifteen months later, the horse became depressed and febrile. A splenic abscess containing Bacteroides ruminicola and Clostridium sporogenes was found at necropsy.
Diagnostic laparoscopy in the horse. Laparoscopy was performed in 5 clinically normal horses. Abdominal fluid protein content and WBC count increased markedly in all horses. Necropsy findings were confined to an increased amount of slightly turbid abdominal fluid. Five examples of applications of laparoscopy in horses with abdominal problems indicated that laparoscopy can be a valuable diagnostic procedure in the horse.