Parietal hernia of the small intestine into the epiploic foramen of a horse.

This research article discusses a unique medical case of a 12-year old horse that suffered from colic, which was eventually identified as a rare form of small-intestinal strangulation known as parietal hernia.

Introduction and Case Presentation

• The study presents the case of a 12-year-old Quarter Horse gelding that exhibited symptoms of colic for 12 hours. The horse did not react positively to medical treatments, leading to a more in-depth investigation of its condition.
• Initial physical and laboratory findings suggested that the horse might be suffering from a pelvic flexure impaction, a common issue where a part of the large intestine forms an impaction.
• The horse was treated for this suspected condition, but it continued to display signs of mild abdominal pain, and its heart rate had increased, prompting the need for an exploratory celiotomy – a surgical incision into the abdominal cavity for examination.

Surgical Findings and Treatment

• The exploratory celiotomy revealed that the horse’s ileum, the final part of the small intestine, was partially entrapped within the epiploic foramen, forming a parietal hernia. The epiploic foramen is a hole between the abdominal cavity and the omental bursa, while a parietal hernia is a protrusion of abdominal contents through a weak spot in the abdominal wall.
• The surgery involved reducing the entrapped intestinal segment without resecting it. Resection, which involves removing a section of an organ or structure, was not required in this case. Post-surgery, the horse made a full recovery.

Conclusions

• Upon retrospective analysis, the research team believes that the delay before surgery was tolerated because the condition was a parietal hernia, which does not result in a complete ileal obstruction. This suggests that the horse’s continued survival and eventual recovery were due to the slow-progressing nature of this specific type of hernia.
• The team concludes that this horse experienced a rare form of small-intestinal strangulation in the epiploic foramen. It did not cause complete obstruction initially, making early detection difficult.