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Home / Equine Research Bank / Animals (Basel) / Primary Jejunal Impactions Resolved via Exploratory Celiotom...
Animals : an open access journal from MDPI2025; 15(16); 2363; doi: 10.3390/ani15162363

Primary Jejunal Impactions Resolved via Exploratory Celiotomy in Six Horses: 2017-2023.

Abstract: Impactions of the jejunum are rarely described in the literature. The current case series describes six cases of adult horses with jejunal impactions with feed material diagnosed by exploratory celiotomy. Horses underwent exploratory celiotomy based off of their degree of pain despite medical management and concerns for a primary strangulating small intestinal lesion. All jejunal impactions were relieved via manual decompression of the impaction into the cecum. None of the cases underwent a resection or anastomosis at the site of impaction. All horses were treated with gastroprotectants (omeprazole or sucralfate) post-operatively; 3/6 horses underwent a gastroscopy and were diagnosed with squamous gastric ulceration prior to treatment. Despite post-operative complications, 5/6 horses survived to hospital discharge.
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Publication Date: 2025-08-12 PubMed ID: 40867692PubMed Central: PMC12383200DOI: 10.3390/ani15162363Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Research Overview

  • This study reports on six adult horses with primary jejunal impactions, a rare type of intestinal blockage, diagnosed and treated surgically via exploratory celiotomy.
  • The research details the surgical approach, post-operative care, and outcomes, including survival rates and complications.

Background and Objective

  • Jejunal impactions involve blockages in the jejunum, a segment of the small intestine, and are infrequently documented in veterinary literature.
  • The objective was to describe clinical cases of jejunal impactions in horses, their diagnosis by surgical exploration, and the outcomes of the interventions.

Study Design and Methods

  • Six adult horses with signs of severe abdominal pain were selected after medical management failed to alleviate symptoms.
  • Exploratory celiotomy, an abdominal surgery to visualize and treat intestinal lesions, was performed based on clinical judgment suspecting strangulating small intestinal lesions.
  • During surgery, impactions were identified in the jejunum caused by feed material leading to intestinal blockage.
  • The surgical treatment involved manual decompression of the impaction, pushing the obstructing material into the cecum rather than removing intestinal segments.
  • No intestinal resection or anastomosis was needed in any case, indicating that the obstruction was resolved without removing bowel tissue.

Post-Operative Treatment and Monitoring

  • All horses received gastroprotective medications, such as omeprazole or sucralfate, to manage or prevent gastric ulcers post-surgery.
  • Three out of the six horses had pre-existing squamous gastric ulcers detected by gastroscopy before initiating gastroprotective therapy.
  • Post-operative complications occurred but were managed sufficiently to allow most horses to recover.

Outcomes and Significance

  • Five out of six horses survived until hospital discharge, showing a high survival rate given the severity of the condition.
  • This case series highlights that primary jejunal impactions can be effectively diagnosed via exploratory celiotomy and treated with non-resective manual decompression techniques.
  • The findings suggest that intestinal resection may often be avoidable in such cases, potentially reducing surgical morbidity.
  • Post-operative use of gastroprotectants is important due to the risk of gastric ulceration, which was evident in half the cases.
  • This research fills a gap in veterinary knowledge regarding the management and prognosis of primary jejunal impactions in horses.

Cite This Article

APA
Willette J, Guinn A, Munsterman A. (2025). Primary Jejunal Impactions Resolved via Exploratory Celiotomy in Six Horses: 2017-2023. Animals (Basel), 15(16), 2363. https://doi.org/10.3390/ani15162363

Publication

Animals : an open access journal from MDPI
ISSN: 2076-2615
NlmUniqueID: 101635614
Country: Switzerland
Language: English
Volume: 15
Issue: 16
PII: 2363

Researcher Affiliations

Willette, Jaclyn
  • Department of Veterinary Clinical Sciences, Iowa State College of Veterinary Medicine, Ames, IA 50011, USA.
Guinn, Alyssa
  • Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA.
Munsterman, Amelia
  • Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA.

Conflict of Interest Statement

The authors declare no conflicts of interest.

References

This article includes 57 references
  1. Siebke A.-U.. Statistische Erhebung über Kurz und Langzeitergebnisse von 718 Operativ Behandelten Kolikpatienten.. Ph.D. Thesis. Der Freien Universität; Berlin, Germany: 1995.
  2. Huskamp B.. Diagnosis and treatment of acute abdominal conditions in the horse: Various types and frequency as seen at the animal hospital in Hochmoor. Proceedings of the Equine Colic Research Symposium; Athens, GA, USA. 28–30 September 1982; pp. 261–272.
  3. Huskamp N.H.. Impaction of the small intestine in the horse. La Colica Nel Cavallo: Esperienze e Aggiornamenti (Proceedings of the International Seminar: An Update on Equine Colic) Societa Italiana Veterinari per Equini; Bologna, Italy: 1998; pp. 71–78.
  4. Freeman D.E., Hammock P., Baker G.J., Goetz T., Foreman J.H., Schaeffer D.J., Richter R., Inoue O., Magid J.H.. Short- and long-term survival and prevalence of postoperative ileus after small intestinal surgery in the horse. Equine Vet. J. Suppl. 2000;32:42–51.
    doi: 10.1111/j.2042-3306.2000.tb05333.xpubmed: 11202382google scholar: lookup
  5. Fleming K., Mueller P.O.. Ileal impaction in 245 horses: 1995–2007. Can. Vet. J. 2011;52:759–763.
    pmc: PMC3119239pubmed: 22210940
  6. Chaffin M.K., Fuenteabla I.C., Schumacher J., Welch R.D., Edwards J.F.. Idiopathic muscular hypertrophy of the equine small intestine: 11 cases (1980–1991). Equine Vet. J. 1992;24:372–378.
    doi: 10.1111/j.2042-3306.1992.tb02858.xpubmed: 1396511google scholar: lookup
  7. Arroyo L.G., Gomez D.E., Martins C.. Equine duodenitis-proximal jejunitis: A review. Can. Vet. J. 2018;59:510–517.
    pmc: PMC5901841pubmed: 29904204
  8. White N.A., Dabareiner R.M.. Treatment of impaction colics. Vet. Clin. N. Am. Equine Pract. 1997;13:243–259.
    doi: 10.1016/S0749-0739(17)30239-0pubmed: 9290183google scholar: lookup
  9. Cribb N.C., Cote N.M., Bouré L.P., Peregrine A.S.. Acute small intestinal obstruction associated with Parascaris equorum infection in young horses: 25 cases (1985–2004). N. Z. Vet. J. 2006;54:338–343.
    doi: 10.1080/00480169.2006.36721pubmed: 17151735google scholar: lookup
  10. Robertson J.T.. Diseases of the small intestine. The Equine Acute Abdomen. Wiley; Hoboken, NJ, USA: 1990; pp. 347–368.
  11. Mair T.S.. Small intestinal obstruction caused by a mass of feedblock containing molasses in 4 horses. Equine Vet. J. 2002;34:532–536.
    doi: 10.2746/042516402776117719pubmed: 12358060google scholar: lookup
  12. Baker G.J., Dodman H.N., Clayton H.M.. Foreign body obstruction of the small intestine of a foal. Vet. Rec. 1974;95:293–295.
    doi: 10.1136/vr.95.13.293pubmed: 4476106google scholar: lookup
  13. Bohanon T.C.. Duodenal impaction in a horse. J. Am. Vet. Med. Assoc. 1988;192:365–366.
    doi: 10.2460/javma.1988.192.03.365pubmed: 3356575google scholar: lookup
  14. Dixon R.T.. Intestinal obstruction in a gelding. Aust. Vet. J. 1965;41:20–22.
    doi: 10.1111/j.1751-0813.1965.tb08778.xpubmed: 14282006google scholar: lookup
  15. Durham A.E.. Flank laparotomy for the removal of a duodenal conglobate in a filly. Equine Vet. Educ. 1998;10:8–11.
    doi: 10.1111/j.2042-3292.1998.tb00838.xgoogle scholar: lookup
  16. Green P, Tong JMJ. Small intestinal obstruction associated with wood chewing in two horses. Vet. Rec. 1988;123:196–198.
    doi: 10.1136/vr.123.8.196pubmed: 3176272google scholar: lookup
  17. Kellam LL, Johnson PJ, Kramer J, Keegan KG. Gastric impaction and obstruction of the small intestine associated with persimmon phytobezoar in a horse. J. Am. Vet. Med. Assoc. 2000;216:1279–1281.
    doi: 10.2460/javma.2000.216.1279pubmed: 10767970google scholar: lookup
  18. Laverty S, Pascoe JR, Williams JW, Funk KA. Cholelith causing duodenal obstruction in a horse. J. Am. Vet. Med. Assoc. 1992;201:751–752.
    doi: 10.2460/javma.1992.201.05.751pubmed: 1399780google scholar: lookup
  19. Turner TA. Trichophytobezoar causing duodenal obstruction in a horse. Compend. Contin. Educ. Pract. Vet. 1986;8:977–978.
  20. Wilson RB, Scruggs DW. Duodenal obstruction associated with persimmon fruit ingestion by two horses. Equine Vet. Sci. 1992;12:26–27.
    doi: 10.1016/S0737-0806(06)81381-Xgoogle scholar: lookup
  21. Freeman DE. Small intestine. In: Auer J.A., Stick J.A., editors. Equine Lameness and Surgery. 3rd ed. Saunders Elsevier; Philadelphia, Pennsylvania: 2007. pp. 408–409.
  22. Little D, Blikslager AT. Factors associated with development of ileal impaction in horses with surgical colic: 78 cases (1986–2000). Equine Vet. J. 2002;34:464–468.
    doi: 10.2746/042516402776117773pubmed: 12358048google scholar: lookup
  23. Proudman CJ, French NP, Trees AJ. Tapeworm infection is a significant risk factor for spasmodic colic and ileal impaction colic in the horse. Equine Vet. J. 1998;30:194–199.
    doi: 10.1111/j.2042-3306.1998.tb04487.xpubmed: 9622319google scholar: lookup
  24. Ruff J, Zetterstrom S, Boone L, Hofmeister E, Smith C, Epstein K, Blikslager A, Fogle C, Burke M. Retrospective analysis of postoperative complications following surgical treatment of ileal impaction in horses managed with manual decompression compared to jejunal enterotomy. Front. Vet. Sci. 2023;10:1156678.
    doi: 10.3389/fvets.2023.1156678pmc: PMC10173877pubmed: 37180077google scholar: lookup
  25. Sykes BW, Hewetson M, Hepburn RJ, Luthersson N, Tamzali Y. European College of Equine Internal Medicine Consensus Statement—Equine Gastric Ulcer Syndrome in Adult Horses. J. Vet. Intern. Med. 2015;29:1288–1299.
    doi: 10.1111/jvim.13578pmc: PMC4858038pubmed: 26340142google scholar: lookup
  26. Vokes J, Lovett A, Sykes B. Equine Gastric Ulcer Syndrome: An Update on Current Knowledge. Animals 2023;13:1261.
    doi: 10.3390/ani13071261pmc: PMC10093336pubmed: 37048517google scholar: lookup
  27. Hewetson M, McGuire C. Equine squamous gastric disease and delayed gastric emptying—The chicken or the egg?. Equine Vet. Educ. 2022;34:460–466.
    doi: 10.1111/eve.13597google scholar: lookup
  28. Berschneider HM, Blikslager AT, Roberts MC. Role of duodenal reflux in nonglandular gastric ulcer disease of the mature horse. Equine Vet. J. 1999;29:24–29.
    doi: 10.1111/j.2042-3306.1999.tb05164.xpubmed: 10696289google scholar: lookup
  29. Bezdekova B, Wohlsein P, Venner M. Chronic severe pyloric lesions in horses: 47 cases. Equine Vet. J. 2020;52:200–204.
    doi: 10.1111/evj.13157pubmed: 31390081google scholar: lookup
  30. Banse H, Terumi Negrão Watanabe T, Abarca-Garcia N, Andrews F, Cruz-Sanabria J, Morales Yniguez JMK, Del Piero F. Relationship of gastric and small intestinal inflammation in equine glandular gastric disease. Equine Vet. J. 2019;51:22.
    doi: 10.1111/evj.13157google scholar: lookup
  31. Van Erck-Westergren E, Ter Woort F. Diet-Induced Changes in Gastric and Faecal Microbiota in Horses: Association with Gastric Ulcer Healing.. Equine Vet. J. 2019;51:21.
  32. Vatistas NJ, Snyder JR, Wilson WD, Drake C, Hildebrand S. Surgical treatment for colic in the foal (67 cases): 1980–1992.. Equine Vet. J. 1996;28:139–145.
    doi: 10.1111/j.2042-3306.1996.tb01606.xpubmed: 8706646google scholar: lookup
  33. Vatistas NJ, Snyder JR, Carlson G, Johnson B, Arthur RM, Thurmond M, Zhou H, Lloyd KL. Cross-sectional study of gastric ulcers of the squamous mucosa in thoroughbred racehorses.. Equine Vet. J. 1999;29:34–39.
    doi: 10.1111/j.2042-3306.1999.tb05166.xpubmed: 10696291google scholar: lookup
  34. Sandin A, Skidell J, Häggström J, Nilsson G. Postmortem findings of gastric ulcers in Swedish horses older than age one year: A retrospective study of 3715 horses (1924–1996). Equine Vet. J. 2000;32:36–42.
    doi: 10.2746/042516400777612044pubmed: 10661383google scholar: lookup
  35. Murray MJ, Grodinsky C, Anderson CW, Radue PF, Schmidt GR. Gastric ulcers in horses: A comparison of endoscopic findings in horses with and without clinical signs.. Equine Vet. J. 1989;21:68–72.
    doi: 10.1111/j.2042-3306.1989.tb05659.xpubmed: 9118110google scholar: lookup
  36. Dukti S, Perkins S, Murphy J, Barr B, Boston R, Southwood L, Bernard W. Prevalence of gastric squamous ulceration in horses with abdominal pain.. Equine Vet. J. 2006;38:347–349.
    doi: 10.2746/042516406777749164pubmed: 16866203google scholar: lookup
  37. Gough S, Hallowell G, Rendle D. A study investigating the treatment of equine squamous gastric disease with long-acting injectable or oral omeprazole.. Vet. Med. Sci. 2020;6:235–241.
    doi: 10.1002/vms3.220pmc: PMC7196684pubmed: 31945806google scholar: lookup
  38. Gorvy DA, Edwards GB, Proudman CJ. Intra-abdominal adhesions in horses: A retrospective evaluation of repeat laparotomy in 99 horses with acute gastrointestinal disease.. Vet. J. 2008;175:194–201.
    doi: 10.1016/j.tvjl.2007.02.016pubmed: 17466544google scholar: lookup
  39. Gerhards H. Incidence and significance of spontaneous and postoperative peritoneal adhesions in horses.. Pferdeheilkunde 1990;6:277–288.
    doi: 10.21836/PEM19900604google scholar: lookup
  40. Parker JE, Fubini SL, Todhunter RJ. Retrospective evaluation of repeat celiotomy in 53 horses with acute gastrointestinal disease.. Vet. Surg. 1989;18:424–431.
    doi: 10.1111/j.1532-950X.1990.tb01118.xpubmed: 2603372google scholar: lookup
  41. Munsterman AS, Kottwitz JJ, Reid Hanson R. Meta-Analysis of the Effects of Adhesion Barriers on Adhesion Formation in the Horse.. Vet. Surg. 2016;45:587–595.
    doi: 10.1111/vsu.12494pubmed: 27305446google scholar: lookup
  42. Freeman DE, Cimprich RE, Richardson DW, Gentile DG, Orsini JA, Tulleners EP, Fetrow JP. Early mucosal healing and chronic changes in pony jejunum after various types of strangulation obstruction.. Am. J. Vet. Res. 1988;49:810–818.
    doi: 10.2460/ajvr.1988.49.06.810pubmed: 3400918google scholar: lookup
  43. Darien BJ. Heparin therapy: Rationale and clinical implications.. Compend. Contin. Educ. Pract. Vet. 1993;15:1273–1276.
  44. Moore BR, Hinchcliff KW. Heparin: A review of its pharmacology and therapeutic use in horses.. J. Vet. Intern. Med. 1994;8:26–35.
    doi: 10.1111/j.1939-1676.1994.tb03192.xpubmed: 8176660google scholar: lookup
  45. Fredericks CM, Kotry I, Holtz G, Askalani A, Serour G. Adhesion prevention in the rabbit with sodium carboxymethylcellulose solutions.. Am. J. Obstet. Gynecol. 1986;155:667–670.
    doi: 10.1016/0002-9378(86)90304-2pubmed: 2428251google scholar: lookup
  46. Moll HD, Schumacher J, Wright JC, Spano JS. Evaluation of sodium carboxymethylcellulose for prevention of experimentally induced abdominal adhesions in ponies.. Am. J. Vet. Res. 1991;52:88–91.
    doi: 10.2460/ajvr.1991.52.01.88pubmed: 2021260google scholar: lookup
  47. Mueller PO, Hunt RJ, Allen D, Parks AH, Hay WP. Intraperitoneal use of sodium carboxymethylcellulose in horses undergoing exploratory celiotomy.. Vet. Surg. 1995;24:112–117.
    doi: 10.1111/j.1532-950X.1995.tb01304.xpubmed: 7778249google scholar: lookup
  48. Freeman DE. Carboxymethylcellulose and adhesion formation in horses.. Vet. Surg. 2009;38:428.
    doi: 10.1111/j.1532-950X.2009.00497_2.xpubmed: 19573112google scholar: lookup
  49. Mueller PO, Harmon BG, Hay WP, Amoroso LM. Effect of carboxymethylcellulose and a hyaluronate-carboxymethylcellulose membrane on healing of intestinal anastomoses in horses.. Am. J. Vet. Res. 2000;61:369–374.
    doi: 10.2460/ajvr.2000.61.369pubmed: 10772099google scholar: lookup
  50. Mueller PO, Hay WP, Harmon B, Amoroso L. Evaluation of a bioresorbable hyaluronate-carboxymethylcellulose membrane for prevention of experimentally induced abdominal adhesions in horses.. Vet. Surg. 2000;29:48–53.
    doi: 10.1111/j.1532-950X.2000.00048.xpubmed: 10653494google scholar: lookup
  51. Morello S, Southwood LL, Engiles J, Slack J, Crack A, Springate CM. Effect of intraperitoneal PERIDAN concentrate adhesion reduction device on clinical findings, infection, and tissue healing in an adult horse jejunojejunostomy model.. Vet. Surg. 2012;41:568–581.
    doi: 10.1111/j.1532-950X.2012.00951.xpubmed: 22632567google scholar: lookup
  52. Dunn DL, Barke RA, Ahrenholz DH, Humphrey EW, Simmons RL. The adjuvant effect of peritoneal fluid in experimental peritonitis. Mechanism and clinical implications.. Ann. Surg. 1984;199:37–43.
    doi: 10.1097/00000658-198401000-00007pmc: PMC1353255pubmed: 6362582google scholar: lookup
  53. Hague BA, Honnas C, Berridge BR, Easter JL. Evaluation of standing postoperative peritoneal lavage for prevention of experimentally induced abdominal adhesions in horses; Proceedings of the American Association of Equine Practitioners; Denver, CO, USA.. 1 January 1996; p. 268.
  54. Nieto JE, Snyder JR, Vatistas NJ, Spier SJ, Van Hoogmoed L. Use of an active intra-abdominal drain in 67 horses.. Vet. Surg. 2003;32:1–7.
    doi: 10.1053/jvet.2003.50013pubmed: 12520484google scholar: lookup
  55. Kuebelbeck KL, Slone DE, May KA. Effect of omentectomy on adhesion formation in horses.. Vet. Surg. 1998;27:132–137.
    doi: 10.1111/j.1532-950X.1998.tb00109.xpubmed: 9525028google scholar: lookup
  56. Cohen ND, Matejka PL, Honnas CM, Hooper RN. Case-control study of the association between various management factors and development of colic in horses.. J. Am. Vet. Med. Assoc. 1995;206:667.
    doi: 10.2460/javma.1995.206.05.667pubmed: 7744689google scholar: lookup
  57. Hillyer MH, Taylor FGR, Proudman CJ, Edwards GB, Smith JE, French NP. Case control study to identify risk factors for simple colonic obstruction and distension colic in horses.. Equine Vet. J. 2010;34:455–463.
    doi: 10.2746/042516402776117746pubmed: 12358047google scholar: lookup

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