FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Equine veterinary journal2026; doi: 10.1002/evj.70203

Roux-en-Y gastrojejunostomy and jejunojejunostomy for pyloric obstruction bypass in a horse and a foal.

Abstract: Gastric outflow obstruction in horses is a rare but challenging condition, often resulting from either congenital anomalies or acquired lesions such as chronic ulceration or pyloric polyps. Conventional surgical bypass procedures, including gastrojejunostomy (GJ) or gastroduodenostomy and less commonly duodenojejunostomy, can restore patency but may lead to postoperative complications. Objective: To describe the presentation, surgical management, and postoperative outcome of two horses-an adult and a foal treated with Roux-en-Y gastrojejunostomy combined with a side-to-side jejunojejunostomy (JJO), emphasising the physiological and clinical advantages of this reconstruction compared with simple GJ. Methods: Case report. Methods: A 7-month-old Selle Français colt (250 kg) with ulcer-associated pyloric obstruction and an 11-year-old Dutch Warmblood gelding (600 kg) with pyloric polyps underwent exploratory laparotomy and Roux-en-Y pyloric bypass consisting of a side-to-side GJ and a JJO between the alimentary and biliary segments. Results: Both horses recovered uneventfully, with no reflux or resolution of reflux after surgery and return to feed within 72 h. No postoperative colic was observed, and follow-up findings were not suggestive of gastric distension after this time. Long-term follow-up (3 years in the colt, 8 months in the adult) revealed normal appetite, weight gain, and absence of recurrent signs. Conclusions: Small number of cases. Conclusions: Roux-en-Y gastrojejunostomy with JJO for pyloric bypass may provide a physiological diversion that maintains biliary continuity and may reduce complications observed with traditional GJ in horses. This configuration may represent a viable alternative to loop gastrojejunostomy for pyloric or duodenal bypass in equine pyloric obstruction, minimising bile reflux and gastric stasis.
© 2026 The Author(s). Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
Get Full Text
Publication Date: 2026-05-31 PubMed ID: 42218917DOI: 10.1002/evj.70203Google 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.
LinkedInCopy
  • 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.

Overview

  • This study reports on the successful use of a Roux-en-Y gastrojejunostomy combined with a jejunojejunostomy surgical technique to bypass pyloric obstruction in two horses, demonstrating improved physiological outcomes and fewer complications compared to traditional bypass surgeries.

Background

  • Gastric outflow obstruction in horses, although rare, is a serious condition often caused by congenital anomalies or acquired lesions such as chronic ulcers or pyloric polyps.
  • Traditional surgical treatments include gastrojejunostomy (GJ), gastroduodenostomy, or duodenojejunostomy, which aim to restore the passage of food but can lead to complications such as reflux and gastric stasis.
  • These complications can have significant impacts on recovery and long-term health in affected horses.

Objective

  • The study aimed to describe the clinical presentation, surgical management, and postoperative outcomes of an adult horse and a foal treated with a Roux-en-Y gastrojejunostomy combined with a side-to-side jejunojejunostomy.
  • It focused on highlighting the physiological and clinical benefits of this surgical configuration versus a simple gastrojejunostomy.

Methods

  • Subjects: Two horses – a 7-month-old Selle Français colt (weight ~250 kg) with ulcer-associated pyloric obstruction and an 11-year-old Dutch Warmblood gelding (weight ~600 kg) with pyloric polyps.
  • Procedure: Both underwent exploratory laparotomy followed by a Roux-en-Y pyloric bypass surgery.
  • The surgical technique involved:
    • Side-to-side gastrojejunostomy (GJ) to create an alternative passage for gastric outflow bypassing the pylorus.
    • Jejunojejunostomy (JJO) connecting the alimentary limb to the biliary limb to maintain continuity of bile flow and reduce bile reflux into the stomach.

Results

  • Both horses recovered without complications, specifically no reflux issues or gastric distension postoperatively.
  • They resumed feeding within 72 hours after surgery indicating prompt functional recovery of gastrointestinal function.
  • Throughout the follow-up period:
    • The colt was monitored for 3 years and the gelding for 8 months.
    • Both maintained normal appetite and experienced healthy weight gain.
    • No recurring digestive symptoms or complications were observed.
  • No postoperative colic events occurred in these cases post-surgery.

Conclusions

  • The Roux-en-Y gastrojejunostomy with side-to-side jejunojejunostomy may offer a more physiological pyloric bypass option for horses compared to traditional gastrojejunostomy.
  • This method appears to preserve normal biliary flow and minimize bile reflux and gastric stasis, which are common issues with traditional techniques.
  • Despite the small sample size, the approach was well tolerated with promising long-term outcomes.
  • The technique could represent a viable alternative surgical option for managing pyloric or duodenal obstruction in horses, potentially improving postoperative recovery and quality of life.
  • Future studies with larger case numbers are needed to confirm these findings and further establish the procedure as a standard treatment.

Cite This Article

APA
Gandini M, Bolz N, Czech C, Hartman M, Giusto G. (2026). Roux-en-Y gastrojejunostomy and jejunojejunostomy for pyloric obstruction bypass in a horse and a foal. Equine Vet J. https://doi.org/10.1002/evj.70203

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

Gandini, Marco
  • Department of Veterinary Sciences, University of Turin, Turin, Italy.
  • Equine Health Center, Turin, Italy.
Bolz, Nico
  • Pferdeklinik Niederlenz, Niederlenz, Switzerland.
Czech, Christian
  • Pferdeklinik Niederlenz, Niederlenz, Switzerland.
Hartman, Myria
  • Pferdeklinik Niederlenz, Niederlenz, Switzerland.
Giusto, Gessica
  • Department of Veterinary Sciences, University of Turin, Turin, Italy.
  • Equine Health Center, Turin, Italy.

References

This article includes 26 references
  1. Bezdekova B, Jahn P, Jahn K. Chronic severe pyloric lesions in horses: clinical, ultrasonographic, endoscopic, and histopathological features.. Equine Vet J 2020;52(5):653–659.
  2. Brabon A, Labens R, Ramachandran A, Dart AJ, Dowling BA. Gastrojejunostomy as a treatment for gastric outflow disorders in four adult horses.. Aust Vet J 2023;101(8):302–307.
  3. Gillis JP, Taylor TS, Puckett MJ. Gastrojejunostomy for management of acute proximal enteritis in a horse.. J Am Vet Med Assoc 1994;204(4):633–635.
  4. Ross MW, Bernard WV, Orsini PG, Ford TS. Surgical management of duodenal obstruction in an adult horse.. J Am Vet Med Assoc 1989;194(9):1312–1314.
  5. Hanson PD, Bartz TA, Stone WC, Darien BJ, Markel MD. Use of a modified Roux‐en‐Y procedure for treatment of pyloroduodenal obstruction in a horse.. J Am Vet Med Assoc 1993;202(7):1119–1122.
  6. Mescpoulhes‐Rivier C, Simon O. Gastrojejunostomy as successful surgical treatment of acute duodenitis/proximal jejunitis in a mare.. Vet Med Austria 2008;95:80–84.
  7. Zedler ST, Embertson RM, Bernard WV, Barr BS, Boston RC. Surgical treatment of gastric outflow obstruction in 40 foals.. Vet Surg 2009;38(5):623–630.
  8. Coleman MC, Slovis NM, Hunt RJ. Long‐term prognosis of gastrojejunostomy in foals with gastric outflow obstruction.. Equine Vet J 2009;41(7):653–657.
  9. Campbell‐Thompson ML, Brown MP, Slone DE, Merritt AM, Moll HD, Levy M. Gastroenterostomy for treatment of gastroduodenal ulcer disease in 14 foals.. J Am Vet Med Assoc 1986;188(8):840–844.
  10. Becht JL, Byars TD. Gastroduodenal ulceration in foals.. Equine Vet J 1986;18(4):307–312.
  11. McGill CA, Bolton JR. Gastric retention associated with a pyloric mass in two horses.. Aust Vet J 1984;61(6):190–191.
  12. Orsini JA, Donawick WJ. Surgical treatment of gastroduodenal obstructions in foals.. Vet Surg 1986;15:205–213.
  13. Li Y, Wang Q, Yang KL, Wang J, Jiang KW, Ye YJ. Uncut Roux‐en‐Y might reduce the rate of reflux gastritis after radical distal gastrectomy: an evidence mapping from a systematic review.. Int J Surg 2022;97:106184.
  14. Fink B, Marvel S, Monnet E. Roux‐en‐Y procedure to reconstruct the upper gastrointestinal tract in six dogs and five cats: a descriptive case series.. Vet Surg 2025;54(5):962–971.
  15. Ikard RW. The Y anastomosis of César roux.. Surg Gynecol Obstet 1989;169:559–567.
  16. Mason GR. Perspectives a century later on the “Ansa en Y” of César roux. Am J Surg 1991;161:262–265.
  17. Tham E, Ang SM, Cowan SW, Yeo CJ, Isenberg GA. César roux—the mind behind the Roux‐en‐Y. Am Surg 2019;85:e14–e17.
  18. Hutchison RL, Hutchison AL. César roux and his original 1893 paper. Obes Surg 2010;20:953–956.
  19. Welsh LK, Murayama KM. Surgical management: Roux‐en‐Y reconstruction. In: Grams J, Perry K, Tavakkoli A, editors. The SAGES manual of foregut surgery. Cham: Springer; 2019. p. 695–708.
  20. Bauck AG, Nelson E, McLain A, Cock G, Sanchez LC, Freeman DE. J‐incision to approach the cranial abdomen in the adult horse. Vet Surg 2021;50(3):600–606.
  21. Giusto G, Gandini M, Amedeo S. Effects of staple size, tissue thickness, and precompression time on staple shape in side‐to‐side jejunocecal anastomosis in specimens obtained from healthy horses at an abattoir. Am J Vet Res 2014;75(7):680–684.
  22. Giusto G, Vercelli C, Gandini M. Comparison of liberal and goal‐directed fluid therapy after small intestinal surgery for strangulating lesions in horses. Vet Rec 2021;188(3):e5.
  23. Valle E, Giusto G, Penazzi L, Giribaldi M, Bergero D, Fradinho MJ. Preliminary results on the association with feeding and recovery length in equine colic patients after laparotomy. J Anim Physiol Anim Nutr 2019;103(4):1233–1241.
  24. Xie H, Wu F, Huang C, Chen Q, Ni Z, Wang S. Traditional Roux‐en‐Y vs uncut Roux‐en‐Y in laparoscopic distal gastrectomy: a randomized controlled study. J Gastrointest Surg 2023;27(6):1098–1105.
  25. Symm WA, Nieto JE, Van Hoogmoed L, Snyder JR. Initial evaluation of a technique for complete cecal bypass in the horse. Vet Surg 2006;35(7):674–677.
  26. 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(5):1288–1299.

Citations

This article has been cited 0 times.
Subscribe to our newsletter
Join 106,245 horse owners like you who receive our email updates on horse health and nutrition.