Incarceration of the small intestine by the epiploic foramen in fifteen horses.
Abstract: In 15 horses with acute abdominal disease, a diagnosis of incarceration of small intestine through the epiploic foramen was made, either at the time of exploratory celiotomy or at necropsy.The horses exhibited signs of moderate to severe abdominal pain and were suffering from hypovolaemic and/or endotoxic shock. Nasogastric intubation produced either gas or fluid, the pH of which was in the range of 5 to 7.2, indicating reflux of small intestinal content into the stomach. Consistent physical findings included absence of gut sounds on auscultation, dilated small intestine palpable on rectal examination, and serosanguineous or xanthochromic fluid from abdominal paracentesis.A ventral midline laparotomy was performed on 11 horses. The incarcerated bowel, which involved the distal jejunum and ileum in 14 horses and jejunum in one horse, varied in length from 26 cm to 13 meters. Reduction of the incarceration was accomplished by gentle traction of the efferent and/or afferent intestine. Infarcted segments of the small intestine were exteriorized, resected, and an end-to-end jejunal anastomosis or an end-to-side jejunocecal anastomosis was performed. A successful postoperative recovery was achieved in three horses.
Publication Date: 1988-04-01 PubMed ID: 17423029PubMed Central: PMC1680899
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- Journal Article
Summary
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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.
Cite This Article
APA
Vasey JR.
(1988).
Incarceration of the small intestine by the epiploic foramen in fifteen horses.
Can Vet J, 29(4), 378-382.
Publication
Researcher Affiliations
References
This article includes 7 references
- Vasey JR, Julian RJ. Elective inversion of the distal ileal stump into the caecum of the horse.. Equine Vet J 1987 May;19(3):223-5.
- Edwards GB. Obstruction of the ileum in the horse: a report of 27 clinical cases.. Equine Vet J 1981 Jul;13(3):158-66.
- Turner TA, Adams SB, White NA. Small intestine incarceration through the epiploic foramen of the horse.. J Am Vet Med Assoc 1984 Mar 15;184(6):731-4.
- Huskamp B. Some problems associated with intestinal surgery in the horse.. Equine Vet J 1977 Jul;9(3):111-5.
- Vaughan JT. Surgical management of abdominal crisis in the horse.. J Am Vet Med Assoc 1972 Dec 1;161(11):1199-212.
- Crowhurst RC, Simpson DJ, McEnery RJ, Greenwood RE. Intestinal surgery in the foal.. J S Afr Vet Assoc 1975 Mar;46(1):59-67.
- Donawick WJ, Christie BA, Stewart JV. Resection of diseased ileum in the horse.. J Am Vet Med Assoc 1971 Nov 1;159(9):1146-9.
Citations
This article has been cited 2 times.- Grzeskowiak RM, Barrett EJ, Rodgerson DH. Cecal entrapment within the epiploic foramen in a mare. Can Vet J 2017 Aug;58(8):842-844.
- 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.
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