Obstruction of the cecocolic orifice by ileocecocolic intussusception following jejunocecostomy in a horse.

This research case study documents surgical complications in a horse that resulted in a fatal intussusception, a medical condition in which a section of the intestine inverts into another section of the intestine. The main complication was the partial obstruction of the cecocolic orifice due to a previous surgery, which caused the horse to show symptoms of discomfort and colic.

Case Presentation

• The study examines the case of a 4-year-old Thoroughbred stallion that showed symptoms of mild to moderate colic, loss of appetite, and decreased water intake, persisting over three weeks.
• Upon ultrasonographic examination, the horse was found to have an intussusception, which can commonly take the form of a cecal inversion or ileocecal intussusception.

Surgical Exploration and Findings

• During the surgical exploration, an ileocecocolic intussusception was discovered with the intussusceptum extending into the right ventral colon. However, the cause of the intussusception remained unknown.
• The intussusception couldn’t be corrected during the surgery, and hence the decision was made to put the horse to sleep.
• A necropsy later revealed a previous surgical procedure, a side-to-side jejunocecostomy. Post this surgery, the ileal stump had intussuscepted into the right ventral colon and become hypertrophied, thus resulting in the partial obstruction of the cecocolic orifice, which in turn caused clinical symptoms of colic in the horse.

Treatment Considerations

• In cases requiring ileocecal or jejunocecal anastomosis, the ileal stump is often left to naturally decompose within the cecum. This approach is taken when treating an irreducible ileocecal intussusception or when the ileal stump is necrotic and cannot be safely removed and reversed.
• This case underlines the need to minimize the size of the ileal stump during surgical procedures to reduce the risk of causing an intussusception.