Equine colic associated with small intestinal epiploic foramen entrapment.

This research explores Intestinal Epiploic Foramen Entrapment (EFE), a significant cause of colic in horses, which often results in euthanasia during surgery due to complications and poor prognosis. The paper discusses identified risk factors, recurrence rates, post-surgery outcomes, and prevention techniques.

Introduction to EFE and Its Impact

• Epiploic Foramen Entrapment (EFE) is highlighted as a major differential diagnosis in horses suffering from colic, a severe, often fluctuating pain in the abdomen that can be fatal.
• Despite its notable impact, studies indicate that short and long-term outcomes for EFE horses have historically been disappointing. Severe complications, like unmanageable intraoperative bleeding, often lead to the euthanisation of the horse during surgery.
• The study substantiates that the ileum part of the intestine is mostly involved in EFE cases.

Risk Factors and Recurrence

• The research demonstrates that a number of risk factors are associated with the development of EFE. The most significant risk factor identified by the research is a behaviour exhibited by horses known as crib-biting or windsucking.
• Despite prevalent risk factors, the recurrence rate of EFE remains relatively low.
• Low recurrence is possibly attributable to the spontaneous closure of Epiploic Foramen (EF) following EFE surgery, a phenomenon observed in about 40% of cases.

Prevention and Improved Outcomes

• Certain laparoscopic techniques are outlined in the research, which could safely obliterate the EF before EFE takes place or as part of the surgical management during laparotomy.
• These preventative measure could potentially benefit horses that are at high risk of developing EFE.
• In the quest for improved outcomes, the authors discuss a range of measures. This includes using recent anatomical insights to better handle entrapped intestines, revising anastomosis techniques, and devising methods to prevent post-operative reflux.