How to perform a percutaneous cecal or colonic trocarization in horses with severe abdominal tympany.
Abstract: Cecal or colonic gas tympany of any cause may result in increased intraabdominal pressure, causing a significant decrease in venous return and cardiac output. Trocarization of the large colon or cecum in the event of large intestinal tympany may resolve gas distension and accompanying increased intraabdominal pressures sufficiently enough to promote resolution of a displaced large colon. Furthermore, trocarization of the medical colic may decrease morbidity and mortality associated with severe intraabdominal hypertension. Methods: This how-to description details the technique of transcutaneous trocarization of the large colon and cecum in the standing horse using a 14-gauge catheter. Conclusions: Trocarization is not a substitute for surgery in the severely gas-distended painful horse exhibiting signs of colic that require surgery; however, it is a viable medical therapy with minimal risk that alleviates gas distention and may assist with correction of a colonic displacement in the horse. Conclusions: The majority of colic episodes involving the large colon can be managed medically without surgical intervention. Auscultation and percussion of the paralumbar fossa area will solicit an audible "ping" (gas/fluid interface), thus targeting the appropriate site for trocarization. Percutaneous trocarization allows for rapid controlled decompression of colonic or cecal tympany, permitting improvement of both ventilation and perfusion. In situations where a displacement or primary colonic or cecal tympany is suspected, trocarisation is deemed successful if the horse has resolution of colic signs and the physical examination parameters return to normal. Trocarization may be clinically advantageous by requiring less pain medication, decreased time in the hospital, decreased costs, and avoidance of surgical intervention; yet, this therapy should not take place of surgical intervention if deemed necessary.
© Veterinary Emergency and Critical Care Society 2022.
Publication Date: 2022-01-20 PubMed ID: 35044068DOI: 10.1111/vec.13123Google Scholar: Lookup
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- Journal Article
Summary
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This research article focuses on the technique of percutaneous cecal or colonic trocarization for treating horses with severe abdominal tympanitis. Trocarization is a medical procedure that reduces gas distension and can possibly rectify a displaced large colon.
Background
- Cecal or colonic gas tympanitis can result in increased intraabdominal pressure, leading to a significant decrease in venous return and cardiac output in horses.
- Trocarization of the large colon or cecum during a case of large intestinal tympanitis can resolve gas distension and accompanying increased intraabdominal pressures, potentially aiding the resolution of a displaced large colon.
- Furthermore, trocarization can also decrease morbidity and mortality associated with severe intraabdominal hypertension.
Methods
- The method involves transcutaneous trocarization of the large colon and cecum in standing horses using a 14-gauge catheter.
- An audible “ping” from auscultation and percussion of the paralumbar fossa area indicates the accurate site for trocarization. This sound signifies the presence of a gas or liquid interface.
Conclusions
- Trocarization is not meant to replace surgery for severely gas-distended horses showing signs of colic requiring surgical intervention. Still, it is a viable medical therapy with minimal risk.
- Most colic episodes involving the large colon can be medically managed without resorting to surgical intervention.
- Percutaneous trocarization allows swift controlled decompression of colonic or cecal tympanitis, aiding in the improvement of both ventilation and perfusion.
- Trocarization is deemed successful if the horse shows resolution of colic signs and the physical examination parameters return to normal following the procedure.
- The procedure can have clinical advantages like lesser requirement for pain medication, reduced hospital stay duration, decreased costs and prevention of surgical intervention.
- Despite its benefits, trocarization should not substitute surgical intervention when necessary.
Cite This Article
APA
Schroeder EL, Gardner AK, Mudge MC.
(2022).
How to perform a percutaneous cecal or colonic trocarization in horses with severe abdominal tympany.
J Vet Emerg Crit Care (San Antonio), 32(S1), 57-62.
https://doi.org/10.1111/vec.13123 Publication
Researcher Affiliations
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA.
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA.
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA.
MeSH Terms
- Animals
- Cecal Diseases / veterinary
- Cecum
- Colic / veterinary
- Colon / surgery
- Horse Diseases / surgery
- Horses
References
This article includes 12 references
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Citations
This article has been cited 1 times.- Dória RGS, Reginato GM, Hayasaka YB, Fantinato Neto P, Passarelli D, Arantes JA. Complications following transcutaneous cecal trocarization in horses with a cattle trocar and a cecal needle. PLoS One 2022;17(11):e0277468.
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