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Cecal entrapment within the epiploic foramen in a mare.

Abstract: An 11-year-old Thoroughbred mare with colic unresponsive to medical treatment underwent exploratory laparotomy. During surgery the cecum was found entrapped within the epiploic foramen from left to right. The entrapped cecum was reduced through the foramen by gentle traction. After reduction of the cecum, rupture of the portal vein was detected. Loss of a large amount of blood prompted euthanasia during surgery. Une jument Thoroughbred âgée de 11 ans atteinte de coliques ne répondant pas au traitement médical a subi une laparatomie exploratoire. Durant la chirurgie, le cæcum a été trouvé encapsulé dans le foramen omental de gauche à droite. Le cæcum encapsulé a été réduit par le foramen à l’aide d’une légère traction. Après la réduction du cæcum, la rupture de la veine porte a été détectée. La perte d’une grande quantité de sang a entraîné l’euthanasie durant la chirurgie.(Traduit par Isabelle Vallières).
Publication Date: 2017-08-02 PubMed ID: 28761191PubMed Central: PMC5508968
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Summary

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An 11-year old Thoroughbred mare experiencing stubborn colic underwent exploratory laparotomy where it was discovered that her cecum was trapped in the epiploic foramen. However, when the entrapped cecum was freed, the portal vein ruptured causing enough blood loss to necessitate euthanasia during the operation.

Background

  • The research pertains to a medical emergency faced by an 11-year-old Thoroughbred mare that was noted to have colic, a severe digestive disorder in horses that was not responding to conventional treatments.
  • The mare had to consequently be subjected to an exploratory surgical process known as laparotomy to figure the cause of the issue.

Findings

  • During the laparotomy, it was found that the mare’s cecum, a part of the large intestine, had become entrapped within the epiploic foramen. The epiploic foramen is a slit-like opening between the liver and the lesser sac of the equine body through which blood vessels, nerves, and lymphatics traverse.
  • This entrapment was causing the colic that was not responsive to medical treatments. The nature of entrapment was such that it had progressed from the left to the right side of the body.

Procedure and Complications

  • The surgical team managed to reduce the entrapped cecum through gentle traction, a procedure whereby the lodged cecum was slowly and carefully pulled out of the foramen.
  • However, post the procedure, it was noted that the portal vein had ruptured. The portal vein is a significant blood vessel responsible for carrying blood from the digestive organs to the liver. This is a grave medical complication and could potentially be life-threatening due to the resultant loss of blood.

Outcome

  • Upon detection of the portal vein’s rupture, substantial blood loss was observed. Despite being in the middle of surgery, the severity of the situation was such that the only humane decision was to euthanize the horse.
  • Therefore, despite initial success in identifying and addressing the entrapped cecum, the surgery ultimately resulted in a fatality due to unforeseen complications during the operation.

Cite This Article

APA
Grzeskowiak RM, Barrett EJ, Rodgerson DH. (2017). Cecal entrapment within the epiploic foramen in a mare. Can Vet J, 58(8), 842-844.

Publication

ISSN: 0008-5286
NlmUniqueID: 0004653
Country: Canada
Language: English
Volume: 58
Issue: 8
Pages: 842-844

Researcher Affiliations

Grzeskowiak, Remigiusz M
  • Hagyard Equine Medical Institute, 4250 Iron Works Pike, 40511 Lexington, Kentucky, USA.
Barrett, Elizabeth J
  • Hagyard Equine Medical Institute, 4250 Iron Works Pike, 40511 Lexington, Kentucky, USA.
Rodgerson, Dwayne H
  • Hagyard Equine Medical Institute, 4250 Iron Works Pike, 40511 Lexington, Kentucky, USA.

MeSH Terms

  • Animals
  • Cecum / pathology
  • Cecum / surgery
  • Colic / diagnosis
  • Colic / surgery
  • Colic / veterinary
  • Fatal Outcome
  • Female
  • Horse Diseases / diagnosis
  • Horse Diseases / surgery
  • Horses
  • Laparotomy / veterinary
  • Portal Vein / injuries

References

This article includes 22 references
  1. Scheidemann W. Beitrag zur diagnostic und therapie der kolik des pferdes die hernia foraminis omentalis. 1989.
  2. Koh CE, Woods SDS, Usatoff V. Foramen of Winslow hernia. Surg Pract 2007;11:81–83.
  3. Vachon AM, Fischer AT. Small intestinal herniation through the epiploic foramen: 53 cases (1987-1993).. Equine Vet J 1995 Sep;27(5):373-80.
  4. Archer DC, Proudman CJ, Pinchbeck G, Smith JE, French NP, Edwards GB. Entrapment of the small intestine in the epiploic foramen in horses: a retrospective analysis of 71 cases recorded between 1991 and 2001.. Vet Rec 2004 Dec 18-25;155(25):793-7.
    pubmed: 15651546
  5. Vasey JR. Incarceration of the small intestine by the epiploic foramen in fifteen horses.. Can Vet J 1988 Apr;29(4):378-82.
    pmc: PMC1680899pubmed: 17423029
  6. Segura D, Garzon N, Nomen C, Prades M, Valls S. Entrapment of large colon through the epiploic foramen in a horse. Equine Vet Educ 1999;11:227–228.
  7. Steenhaut M, Vandenreyt I, Van Roy M. Incarceration of the large colon through the epiploic foramen in a horse.. Equine Vet J 1993 Nov;25(6):550-1.
  8. Foerner JJ, Ringle MJ, Junkins DS, Fischer AT, MacHarg MA, Phillips TN. Transection of the pelvic flexure to reduce incarceration of the large colon through the epiploic foramen in a horse.. J Am Vet Med Assoc 1993 Nov 1;203(9):1312-3.
    pubmed: 8253626
  9. Martin BB Jr, Freeman DE, Ross MW, Richardson DW, Johnston JK, Orsini JA. Cecocolic and cecocecal intussusception in horses: 30 cases (1976-1996).. J Am Vet Med Assoc 1999 Jan 1;214(1):80-4.
    pubmed: 9887945
  10. Dabareiner RM, White NA 2nd. Diseases and surgery of the cecum.. Vet Clin North Am Equine Pract 1997 Aug;13(2):303-15.
    pubmed: 9290185doi: 10.1016/s0749-0739(17)30241-9google scholar: lookup
  11. Getty R. Sisson and Grossman’s Anatomy of Domestic Animals. 1975.
  12. Archer DC, Pinchbeck GK, French NP, Proudman CJ. Risk factors for epiploic foramen entrapment colic: an international study.. Equine Vet J 2008 May;40(3):224-30.
    pubmed: 18267890doi: 10.2746/042516408x266079google scholar: lookup
  13. Archer DC, Freeman DE, Doyle AJ, Proudman CJ, Edwards GB. Association between cribbing and entrapment of the small intestine in the epiploic foramen in horses: 68 cases (1991-2002).. J Am Vet Med Assoc 2004 Feb 15;224(4):562-4.
    pubmed: 14989551doi: 10.2460/javma.2004.224.562google scholar: lookup
  14. Freeman DE, Schaeffer DJ. Age distributions of horses with strangulation of the small intestine by a lipoma or in the epiploic foramen: 46 cases (1994-2000).. J Am Vet Med Assoc 2001 Jul 1;219(1):87-9.
    pubmed: 11439778doi: 10.2460/javma.2001.219.87google scholar: lookup
  15. van Bergen T, Doom M, van den Broeck W, Wiemer P, Clegg PD, Cornillie P, Martens A. A topographic anatomical study of the equine epiploic foramen and comparison with laparoscopic visualisation.. Equine Vet J 2015 May;47(3):313-8.
    pubmed: 24750299doi: 10.1111/evj.12282google scholar: lookup
  16. Munsterman AS, Hanson RR, Cattley RC, Barrett EJ, Albanese V. Surgical technique and short-term outcome for experimental laparoscopic closure of the epiploic foramen in 6 horses.. Vet Surg 2014 Feb;43(2):105-13.
  17. van Bergen T, Wiemer P, Bosseler L, Ugahary F, Martens A. Development of a new laparoscopic Foramen Epiploicum Mesh Closure (FEMC) technique in 6 horses.. Equine Vet J 2016 May;48(3):331-7.
    pubmed: 25676675doi: 10.1111/evj.12427google scholar: lookup
  18. van Bergen T, Wiemer P, Schauvliege S, Paulussen E, Ugahary F, Martens A. Laparoscopic Evaluation of the Epiploic Foramen after Celiotomy for Epiploic Foramen Entrapment in the Horse.. Vet Surg 2016 Jul;45(5):596-601.
    pubmed: 27296464doi: 10.1111/vsu.12493google scholar: lookup
  19. Archer DC, Pinchbeck GL, Proudman CJ. Factors associated with survival of epiploic foramen entrapment colic: a multicentre, international study.. Equine Vet J Suppl 2011 Aug;(39):56-62.
  20. Proudman CJ, Edwards GB, Barnes J, French NR. Factors affecting long-term survival of horses recovering from surgery of the small intestine.. Equine Vet J 2005 Jul;37(4):360-5.
    pubmed: 16028629doi: 10.2746/0425164054529481google scholar: lookup
  21. Davis DM, McClure JR, Bertone AL, Cazayoux CA, Vice JD. Hypoglycemia and hepatic ischemic necrosis after small intestinal incarceration through the epiploic foramen in a horse.. Cornell Vet 1992 Apr;82(2):173-9.
    pubmed: 1623731
  22. Livesey MA, Little CB, Boyd C. Fatal hemorrhage associated with incarceration of small intestine by the epiploic foramen in three horses.. Can Vet J 1991 Jul;32(7):434-6.
    pmc: PMC1481000pubmed: 17423823

Citations

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