Jejunal intussusception: a complication of functional end-to-end stapled anastomoses in two ponies.

This research studied two cases of jejunojejunal intussusception in ponies after undergoing jejunal resection and stapled functional end-to-end anastomosis, and discusses the potential cause and preventative guidance.

Overview of the Research

• This research paper discusses the occurrence of jejunojejunal intussusception, a condition where a portion of the jejunum – a part of the small intestine – slides into an adjacent part, in two ponies who underwent jejunal resection and stapled functional end-to-end (FEE) anastomosis. This is a surgical technique in which the two ends of the intestine are reconnected after a portion has been removed.
• The paper identifies the location that was the lead point of the intussusception as the place where the FEE anastomosis was performed. In other words, the spot where the intestines were stapled together was the starting point of the intussusception.

Details about the Method and Findings

• In both cases discussed, the free ends of the jejunum that were stapled together were oversewn with sutures in an inverting pattern. This is a technique used to further reinforce the connection, presumably to ensure that it stays together post-operation.
• The paper hypothesized that the intussusception may have occurred because the FEE anastomosis created an acute, or sharp, angle in the intestine. This abrupt change in direction could have impeded the normal flow of ingesta – the substances being digested – resulting in changes to the normal intestinal motility, or movement, and created conditions that led to intussusception.
• Further, the authors suggest that because the oversewn, or blind, ends of the intestine served as the lead point for the intussusception, it might not be advisable to oversew the stapled anastomotic ends in future operations.

Conclusion and Recommendations

• In conclusion, this paper proposes the acute angle formed by FEE anastomosis and the oversewing of the free intestinal ends as potential triggers for jejunojejunal intussusception in ponies, based on the two cases studied.
• As a result, it suggests reconsideration of the practice of oversewing the stapled anastomotic ends in this type of operation for the prevention of intussusception. This could be a valuable guide for veterinarians performing similar surgeries in equine patients.