Retrospective analysis of postoperative complications following surgical treatment of ileal impaction in horses managed with manual decompression compared to jejunal enterotomy.
Abstract: The objective of this study was to compare the occurrence of post-operative complications and survival to discharge in horses with ileal impactions resolved by manual decompression compared with jejunal enterotomy. Unassigned: A total of 121 client-owned horses undergoing surgical correction of an ileal impaction at three teaching hospitals. Unassigned: Data from the medical records of horses undergoing surgical correction of an ileal impaction was retrospectively collected. Post-operative complications, survival to discharge, or post-operative reflux present were evaluated as dependent variables and pre-operative PCV, surgery duration, pre-operative reflux, and type of surgery were evaluated as independent variables. Type of surgery was divided into manual decompression ( = 88) and jejunal enterotomy ( = 33). Unassigned: There were no significant differences in development of minor complications, development of major complications, presence of post-operative reflux, amount of post-operative reflux, and survival to discharge between horses that were treated with manual decompression and those treated with distal jejunal enterotomy. Pre-operative PCV and surgery duration were significant predictors of survival to discharge. Unassigned: This study showed that there are no significant differences in post-operative complications and survival to discharge in horses undergoing distal jejunal enterotomy versus manual decompression for correction of ileal impaction. Pre-operative PCV and duration of surgery were found to be the only predictive factors of survival to discharge. Based on these findings, distal jejunal enterotomy should be considered earlier in horses with moderate to severe ileal impactions identified at surgery.
Copyright © 2023 Ruff, Zetterstrom, Boone, Hofmeister, Smith, Epstein, Blikslager, Fogle and Burke.
Publication Date: 2023-04-27 PubMed ID: 37180077PubMed Central: PMC10173877DOI: 10.3389/fvets.2023.1156678Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
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.
The study comparatively analyses the post-surgery survival rates and complications in horses that underwent two different procedures – manual decompression and jejunal enterotomy – to resolve ileal impactions. The researchers concluded that both methods have no significant difference in post-surgery complications and discharge survival. However, pre-operative packed cell volume (PCV) levels and operation duration were effective in predicting survival rates post-discharge.
Study Objective and Methodology
- This research aimed to assess post-operative complications and survival rates in horses that underwent surgery for ileal impaction resolution.
- The study involved 121 client-owned horses at three teaching veterinary hospitals that required surgical treatment for ileal impaction.
- The cases were divided into two groups: those who underwent manual decompression (88 horses) and those who underwent jejunal enterotomy (33 horses).
- The researchers retrospectively collected and analyzed data including pre-operative PCV, surgery duration, pre-operative reflux, and surgery type.
Findings and Interpretation
- The study found that there were no significant differences in minor or major complications, post-operative reflux, discharge survival rates, and post-surgery reflux amounts between the two surgical methods.
- The pre-operative PCV and surgery duration were significant predictors of survival after discharge. This implies that horses with normal PCV levels and shorter surgery durations are more likely to survive post-surgery.
Study Conclusion and Recommendations
- The research concluded that both manual decompression and jejunal enterotomy had comparable outcomes when used to correct ileal impaction in horses. Neither surgical procedure was significantly safer or more effective than the other.
- The study recommends considering distal jejunal enterotomy earlier in horses with moderate to severe ileal impactions identified at surgery due to its comparable efficacy and safety to manual decompression.
Cite This Article
APA
Ruff J, Zetterstrom S, Boone L, Hofmeister E, Smith C, Epstein K, Blikslager A, Fogle C, Burke M.
(2023).
Retrospective analysis of postoperative complications following surgical treatment of ileal impaction in horses managed with manual decompression compared to jejunal enterotomy.
Front Vet Sci, 10, 1156678.
https://doi.org/10.3389/fvets.2023.1156678 Publication
Researcher Affiliations
- Department of Clinical Sciences, North Carolina State University, Raleigh, NC, United States.
- Department of Clinical Sciences, Auburn University, Auburn, AL, United States.
- Department of Clinical Sciences, Auburn University, Auburn, AL, United States.
- Department of Clinical Sciences, Auburn University, Auburn, AL, United States.
- Department of Clinical Sciences, New Bolton Center, University of Pennsylvania, Philadelphia, PA, United States.
- Department of Clinical Sciences, University of Georgia, Athens, GA, United States.
- Department of Clinical Sciences, University of Georgia, Athens, GA, United States.
- Department of Clinical Sciences, North Carolina State University, Raleigh, NC, United States.
- Department of Clinical Sciences, North Carolina State University, Raleigh, NC, United States.
- Department of Clinical Sciences, North Carolina State University, Raleigh, NC, United States.
Conflict of Interest Statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
References
This article includes 23 references
- Freeman DE. Jejunum and Ileum. In: Auer JA, Stick JA, Kümmerle JM, Prange T, editors. Equine surgery. 5th ed. St. Louis, MO: Elsevier; (2019). 536–74.
- Fleming K, Mueller PO. Ileal impaction in 245 horses: 1995-2007.. Can Vet J 2011 Jul;52(7):759-63.
- Hanson RR, Wright JC, Schumacher J, Baird AN, Humburg J, Pugh DG. Surgical reduction of ileal impactions in the horse: 28 cases.. Vet Surg 1998 Nov-Dec;27(6):555-60.
- Mair TS, Smith LJ. Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 3: Long-term complications and survival.. Equine Vet J 2005 Jul;37(4):310-4.
- Fogle CA, Gerard MP, Elce YA, Little D, Morton AJ, Correa MT, Blikslager AT. Analysis of sodium carboxymethylcellulose administration and related factors associated with postoperative colic and survival in horses with small intestinal disease.. Vet Surg 2008 Aug;37(6):558-63.
- Roussel AJ Jr, Cohen ND, Hooper RN, Rakestraw PC. Risk factors associated with development of postoperative ileus in horses.. J Am Vet Med Assoc 2001 Jul 1;219(1):72-8.
- Cohen ND, Lester GD, Sanchez LC, Merritt AM, Roussel AJ Jr. Evaluation of risk factors associated with development of postoperative ileus in horses.. J Am Vet Med Assoc 2004 Oct 1;225(7):1070-8.
- Little D, Tomlinson JE, Blikslager AT. Post operative neutrophilic inflammation in equine small intestine after manipulation and ischaemia.. Equine Vet J 2005 Jul;37(4):329-35.
- Hopster-Iversen C, Hopster K, Staszyk C, Rohn K, Freeman D, Rötting AK. Influence of mechanical manipulations on the local inflammatory reaction in the equine colon.. Equine Vet J Suppl 2011 Aug;(39):1-7.
- Kersjes AW, Bras GE, Németh F, van der Velden MA, Firth EC. Results of operative treatment of equine colic with special reference to surgery of the ileum.. Vet Q 1988 Jan;10(1):17-25.
- Hopster-Iversen CC, Hopster K, Staszyk C, Rohn K, Freeman DE, Rötting AK. Effects of experimental mechanical manipulations on local inflammation in the jejunum of horses.. Am J Vet Res 2014 Apr;75(4):385-91.
- Davis HA, Munsterman A. Ileal impaction and jejunal enterotomy in a 4-month-old Arabian filly.. Can Vet J 2012 Jan;53(1):71-4.
- Edwards GB. Resection and anastomosis of small intestine: current methods applicable to the horse.. Equine Vet J 1986 Jul;18(4):322-30.
- Parks AH, Doran RE, White NA, Allen D, Baxter GM. Ileal impaction in the horse: 75 cases.. Cornell Vet 1989 Jan;79(1):83-91.
- Edwards GB. Obstruction of the ileum in the horse: a report of 27 clinical cases.. Equine Vet J 1981 Jul;13(3):158-66.
- Embertson RM, Colahan PT, Brown MP, Peyton LC, Schneider RK, Granstedt ME. Ileal impaction in the horse.. J Am Vet Med Assoc 1985 Mar 15;186(6):570-2.
- Adams SB, McIlwraith CW. Abdominal crisis in the horse: a comparison of pre-surgical evaluation with surgical findings and results. Vet Surg (1978) 7:63–9.
- Reeves MJ, Curtis CR, Salman MD, Hilbert BJ. Prognosis in equine colic patients using multivariable analysis.. Can J Vet Res 1989 Jan;53(1):87-94.
- Reeves MJ, Curtis CR, Salman MD, Reif JS, Stashak TS. A multivariable prognostic model for equine colic patients. Prev Vet Med (1990) 9:241–57.
- Parry BW, Anderson GA, Gay CC. Prognosis in equine colic: a study of individual variables used in case assessment.. Equine Vet J 1983 Oct;15(4):337-44.
- Kos VK, Kramaric P, Brloznik M. Packed cell volume and heart rate to predict medical and surgical cases and their short-term survival in horses with gastrointestinal-induced colic.. Can Vet J 2022 Apr;63(4):365-372.
- Suthers JM, Pinchbeck GL, Proudman CJ, Archer DC. Survival of horses following strangulating large colon volvulus.. Equine Vet J 2013 Mar;45(2):219-23.
- Proudman CJ, Smith JE, Edwards GB, French NP. Long-term survival of equine surgical colic cases. Part 2: modelling postoperative survival.. Equine Vet J 2002 Jul;34(5):438-43.
Citations
This article has been cited 2 times.- Venter AC, Țica O, Cheseli A, Daina CM, Oswald IG, Beiușanu C, Andreescu G, Brihan I. Diagnostic Value of Multimodal Imaging and Histopathology in Gallstone Ileus: A Retrospective Analysis. Diagnostics (Basel) 2025 Aug 12;15(16).
- Willette J, Guinn A, Munsterman A. Primary Jejunal Impactions Resolved via Exploratory Celiotomy in Six Horses: 2017-2023. Animals (Basel) 2025 Aug 12;15(16).
Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists
