Short-and long-term evaluation of surgical treatment of strangulating obstructions of the small intestine in horses: a review of 224 cases.

The study reviews 224 cases of horses that underwent surgery for strangulating obstructions in the small intestine. The results show that 50% survived and got discharged, while 84% of the survivors were still alive after one year. The study concludes that such operations still have a generally poor prognosis but those who survive the immediate post-operative period can anticipate a fair to good outcome.

Objective and Methodology

• The researchers conducted a retrospective study reviewing 224 cases of horses that underwent surgery to treat strangulating obstructions in the small intestine.
• The purpose of the study was to evaluate the short-term and long-term outcomes of these surgeries and identify factors that influenced the results.

Findings

• Out of 224 horses, 54 were euthanized and 5 died during surgery, leaving 165 horses (73%) that recovered from the operation.
• 53 of the recovered horses were later euthanized or died in the clinic, while 112 (50%) managed to be discharged from the hospital.
• After a year, a follow-up of 90 available horses showed that 76 (84%) were still alive.
• The main causes of death or euthanasia in the immediate post-operative period were post-operative paralytic ileus, (adhesive) peritonitis, and intra-abdominal bleeding.
• After the horses left the hospital, the main causes of complications were (adhesive) peritonitis and recurrent colic.
• Among the horses that lived for at least one year, 16% experienced occasional colic, 12% had problems with wound healing at the incision site, and 4% developed a thrombosis in the jugular vein.
• 88% of the one-year survivors were in good health and could perform at the same level as before surgery.
• The type of surgical intervention (i.e., enterotomy, enterectomy) did not significantly affect the surgery’s outcome, however, the type of anastomosis did, with end-to-end jejunojejunostomy having better prognosis than side-to-side jejunocaecostomy.

Conclusions and Future Directions

• The researchers concluded that surgery for strangulating obstructions in the small intestine still holds a poor to guarded prognosis, with the highest mortality rates during the peri-operative period.
• However, horses that recover from surgery and can be discharged from the hospital have a fair to good prognosis.
• Improving surgical outcomes may require improved surgical handling of the ileal stump and prevention of post-operative ileus and adhesion formation.