Response to early repeat celiotomy in horses after a surgical treatment of jejunal strangulation.
Abstract: To determine the outcome after early repeat celiotomy in horses operated for jejunal strangulation. Methods: Retrospective case series. Methods: Horses (n = 22) that underwent repeat celiotomy for postoperative reflux (POR) and/or postoperative colic (POC) that did not improve within 48 hours from onset after initial surgical treatment of strangulating jejunal lesions by jejunojejunostomy (n = 14) or no resection (n = 8). Methods: Medical records were reviewed for clinical signs, duration of signs before repeat surgery, surgical findings and treatment, and outcome. Survival was documented by phone call at long-term follow-up. The influence of POC and POR on timing of surgery were analyzed. Long-term survival was examined by Kaplan-Meier analyses. Results: Repeat celiotomy was performed at a median of 57 hours after initial surgery and 16.5 hours from onset of signs, and earlier in horses with POC compared with POR (P < .05). A total of 3/22 horses were euthanatized under anesthesia. A total of 9 of 11 horses with initial jejunojejunostomy required resection of the original anastomosis due to anastomotic complications. In 8 horses without resection, second surgery included resection (4) or decompression (4). Repeat celiotomy was successful in 13/16 horses with POR. Repeat celiotomy eliminated POC in all horses (n = 9). A total of 19 horses were recovered from anesthesia and all survived to discharge. Incisional infections were diagnosed in 13/17 horses where both surgeries were performed through the same ventral median approach, and hernias developed in 4/13 infected incisions. Median survival time was 90 months. Conclusions: Repeat celiotomy can eliminate signs of POR and/or POC, and the additional surgery does not appear to aggravate POR. Criteria for repeat celiotomy in this study could provide guidelines for managing POC and POR after surgery for jejunal strangulation.
© 2017 The American College of Veterinary Surgeons.
Publication Date: 2017-05-29 PubMed ID: 28556997DOI: 10.1111/vsu.12670Google Scholar: Lookup
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- Journal Article
Summary
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This research explored the effectiveness of repeat surgery (celiotomy) in horses following a previous surgical treatment for a condition called jejunal strangulation. The results showed that a second surgery was useful for managing post operation complications, and it did not increase the challenges of recovery.
Methodology
The research was designed as a retrospective case series. It reviewed 22 cases of horses that underwent repeat celiotomy due to either postoperative reflux (POR) or postoperative colic (POC) which did not improve within two days after the initial surgical treatment. The initial surgeries they underwent were either jejunojejunostomy (14 cases) or no resection (8 cases). Medical records were thoroughly investigated for clinical signs, duration of signs before the repeat surgery, and the results of the surgeries. Long-term survival was also documented through phone call follow-ups. Statistical processes like Kaplan-Meier analyses were used to assess long term survival.
Results
- The repeat surgery was usually conducted about 57 hours after the initial surgical operation. For horses that reported signs of complications, this was done 16.5 hours from the onset of the signs.
- Earlier surgery was done for horses with postoperative colic compared to those with postoperative reflux.
- About three horses were euthanized under anesthesia.
- For 9 out of 11 horses that underwent the initial jejunojejunostomy, resection of the original anastomosis was required due to complications.
- Those that did not undergo resection during the first surgery, the second surgery involved either resection (4 horses) or decompression (4 horses).
- 13 out of 16 horses with postoperative reflux were successfully treated with repeat celiotomy.
- All 9 horses with postoperative colic saw the elimination of the colic symptoms after the repeat celiotomy.
- Of the 19 horses that recovered from anesthesia, all of them survived until discharge.
- Incisional infections were found in 13 out of 17 cases where both surgeries were performed through the same ventral median approach. Four of the infected incisions developed hernias.
- Median survival time post-surgery was 90 months.
Conclusions
The study concluded that repeating celiotomy could effectively eliminate signs of postoperative colic and reflux. Additionally, the follow-up surgery did not seem to increase the likelihood of postoperative reflux. The criteria used in the study for repeat celiotomy could offer insights and guidelines for managing postoperative reflux and postoperative colic after surgical treatment of jejunal strangulation.
Cite This Article
APA
Bauck AG, Easley JT, Cleary OB, Graham S, Morton AJ, Rötting AK, Schaeffer DJ, Smith AD, Freeman DE.
(2017).
Response to early repeat celiotomy in horses after a surgical treatment of jejunal strangulation.
Vet Surg, 46(6), 843-850.
https://doi.org/10.1111/vsu.12670 Publication
Researcher Affiliations
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida.
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida.
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida.
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida.
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida.
- Department of Comparative Biosciences, University of Illinois, College of Veterinary Medicine, Urbana, Illinois.
- Department of Comparative Biosciences, University of Illinois, College of Veterinary Medicine, Urbana, Illinois.
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida.
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida.
MeSH Terms
- Animals
- Colic / surgery
- Colic / veterinary
- Female
- Gastroesophageal Reflux / surgery
- Gastroesophageal Reflux / veterinary
- Horse Diseases / surgery
- Horses
- Intestinal Obstruction / surgery
- Intestinal Obstruction / veterinary
- Jejunum / pathology
- Jejunum / surgery
- Laparotomy / veterinary
- Male
- Postoperative Period
- Reoperation / veterinary
- Retrospective Studies
- Treatment Outcome
Citations
This article has been cited 2 times.- Griessel TS, Muñoz Morán JA, Byaruhanga C, Smit Y. A single-centre retrospective study of surgical site infection following equine colic surgery (2013‒2021). Vet Rec 2025 May 17;196(10):e5227.
- Lawson AL, Sherlock CE, Ireland JL, Mair TS. Equine nutrition in the post-operative colic: Survey of Diplomates of the American Colleges of Veterinary Internal Medicine and Veterinary Surgeons, and European Colleges of Equine Internal Medicine and Veterinary Surgeons. Equine Vet J 2021 Sep;53(5):1015-1024.
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