Partial typhlectomy and ileocolostomy for treatment of nonreducible cecocolic intussusception in a horse.

This study describes the surgical treatment of severe digestive obstruction in a young horse. By removing a portion of the horse’s cecum and joining the ileum to the colon, veterinarians were able to save the horse’s life, despite numerous post-surgery complications.

Identifying the Problem

• The study details the case of a two-year-old Standardbred horse who had been experiencing intermittent signs of colic—a severe, often fluctuating pain in the abdomen—over three days.
• Upon examination, the horse was found to have cecocolic intussusception, a condition in which one segment of the bowel slides into an adjacent segment, similar to the collapsing segments of a telescope. This can cause serious obstruction, affecting the passage of food and potentially damaging or necrotizing the affected sections.
• The entire cecum (a pouch at the beginning of the large intestine that stores food for bacterial fermentation) and the right ventral colon were edematous (swollen with excessive fluid) and necrotic (dead tissues), making manual reduction—physically manipulating the bowel to resolve the obstruction—impossible.

Surgical Intervention

• The veterinary team performed a colotomy (a surgical incision into the colon) to gain access to the affected region.
• A partial typhlectomy was then performed. This is a surgical procedure which involves the removal of part of the cecum. This was necessary because of the extensive damage and necrosis in the cecum.
• Additionally, an ileocolostomy was also conducted. This is a surgical procedure where the ileum—the final section of the small intestine—is connected directly to the colon. This helps bypass the damaged areas, and allows for the normal passage of digestive material.
• To prevent the cecal base from turning inside out (a condition called eversion), the site where the bowel had originally telescoped into itself was sutured tightly.

Postoperative Complications and Recovery

• The horse experienced multiple complications after the surgery, including peritonitis (inflammation of the tissue lining the abdomen), thrombophlebitis (vein inflammation due to a blood clot), anemia (a lack of healthy red blood cells), and hypoproteinemia (abnormally low levels of protein in the blood).
• All these postoperative conditions were managed and treated appropriately by the medical team.
• A year after the initial surgery, the horse was reported to be healthy and back in training—a testament to the successful intervention and careful postoperative care.