Obstruction of equine small intestine associated with focal idiopathic eosinophilic enteritis: an emerging disease?

The research paper is about Idiopathic Focal Eosinophilic Enteritis (IFEE), a rare disease in horses, discussing its clinical, surgical and histological features as well as post-operative progress in 12 affected horses. It shows that IFEE is an infrequent but important cause of small intestine obstruction and that surgical intervention can resolve the issue.

Introduction and Objectives

• The researchers aim to detail the clinical features, surgical treatments, and histology of 12 horses affected by IFEE—a disease that was not identified in the authors’ hospital population before 2000.
• The rarity of this condition and its potential impact on equine health highlight the importance of the study.

Methods – Diagnosis and Treatment

• In all 12 cases, the diagnosis of IFEE was established through laparotomy and validated by histological examination of the resected abnormal small intestine.
• The presentation of IFEE commonly included colic symptoms and jejunal obstruction characterized by visibly evident and palpably thickened serosal plaques or circumferential constrictions.
• The essential treatment involved surgical resection of the affected intestine, which was performed on ten horses out of the twelve.

Results – Recovery and Complications

• Seven out of the ten horses that underwent surgery showed complete recovery.
• In one case where surgical resection was not performed, the horse suffered a post-operative re-obstruction at one of the lesions from the ingesta.

Conclusions – Significance of Histological Examination

• Extensive examination of the resected intestines confirmed a severe and comprehensive enteritis characterized by the dominance of eosinophilic white blood cells, with no evidence of helminths.
• The exact cause behind this inflammation remains unknown.
• The study concludes by emphasizing the uncommon yet significant role of IFEE in causing small intestinal obstruction in horses and that surgical resection can be a potentially curative measure.
• Furthermore, it highlights the importance of histological examination in diagnosing IFEE, suggesting that the gross lesions may be underrecognized without these tests.