Elective inversion of the distal ileal stump into the caecum of the horse.

This study introduces a new method to deal with necrotic small intestine in horses which cannot be exteriorized due to its close anatomical positioning. The procedure involves inverting the affected ileum into the caecum, reducing the risk of peritonitis. The technique was trialled on a total of nine horses with encouraging results.

Research Purpose and Background

• The study was undertaken to tackle a surgical challenge in horses where the distal 30-40cm of the ileum, a part of the small intestine, cannot be exteriorised due to its close association with the base of the caecum, a part of the large intestine.
• The challenge arises when this specific segment of the ileum becomes avascular and necrotic (devoid of blood supply and thus, dead or dying), needing to be removed.

Methodology and Technical Approach

• The researchers proposed a surgical method to resolve this issue. The technique involves inverting, or turning inside out, the distal stump (the end part) of the ileum into the lumen (the cavity) of the caecum.
• Post inversion, they perform a conventional ileocaecal or jejunocaecal anastomosis, which is a surgical joining of the two parts of the intestine.
• This method avoids the risk of peritonitis, an infection in the abdominal lining, that may occur if the usual technique of using a Parker-Kerr suture to oversew the dying ileal stump breaks open.

Implementation and Evaluation

• This new method was carried out on a total of nine horses. Five of them were clinically normal, and four had necrotic terminal 30 to 40 cm of the ileum. The idea was to test the technique in both normal and pathological conditions.
• Postoperative clinical observations and autopsy results of the horses, presumably to evaluate the success and impact of the technique, were discussed but the results are not mentioned in the abstract.