Incarceration of the small intestine by the epiploic foramen in fifteen horses.

This research discussed the diagnosis and treatment of 15 horses experiencing acute abdominal conditions, specifically the incarceration of the small intestine through the epiploic foramen. The condition was identified either during an exploratory surgery known as celiotomy or during a necropsy. The paper detailed the findings, surgical procedures undertaken, and the recovery of the animals.

Signs and Diagnosis

• The horses in the study exhibited symptoms of moderate to severe abdominal pain and were found to be in a state of hypovolemic or endotoxic shock, both serious conditions related to a severe drop in blood pressure or release of endotoxins into the bloodstream, respectively.
• The process of nasogastric intubation was employed, which involved inserting a tube through the nose into the stomach. The resulting content, which was either gas or fluid, had a pH ranging from 5 to 7.2, indicating that the small intestine’s contents were flowing back into the horses’ stomachs.
• Also, consistent physical examinations showed an absence of gut sounds when listening with a stethoscope, dilation of the small intestine when palpated rectally, and either serosanguineous (containing both blood and serum) or xanthochromic (yellow-colored) fluid when tapping and removing fluid from the peritoneal cavity (abdominal paracentesis).

Surgical Procedures

• A ventral midline laparotomy, a type of surgery involving an incision along the midline of the abdomen, was performed on 11 of the horses. This procedure allowed veterinarians to directly see and manipulate the horses’ gastrointestinal tracts.
• The incarcerated portion of the bowel most often involved the distal, or furthest away, parts of the jejunum and ileum, which are parts of the small intestine. The portion of the intestine passing through the epiploic foramen was found to range from 26 cm to 13 meters in length.
• The procedure to reduce the incarceration, or relieving the intestine from the abnormal opening, was achieved by gently pulling (traction) of the efferent (outgoing) and/or afferent (incoming) intestine.
• In cases where the blood supply to the intestine had been cut off (infarction), the affected intestinal segments were removed (resected), and the remaining ends were connected together (anastomosis). Either an end-to-end jejunal anastomosis (connecting the two ends of the jejunum) or an end-to-side jejunocecal anastomosis (connecting the jejunum to the cecum, a pouch located at the beginning of the large intestine) was performed.

Outcome and Recovery

• Postoperative recovery was considered successful in three of the horses, though the paper does not provide detailed indications of the recovery criteria or further details about the other twelve horses’ outcomes.