Surgical treatment of gastric outflow obstruction in 40 foals.
Abstract: To report short- and long-term survival and factors affecting outcome of foals after surgical correction of gastric outflow obstruction. Methods: Case series. Methods: Foals (n=40) aged 5-180 days. Methods: Clinical signs, laboratory data, diagnostic imaging, surgical findings, surgical procedures, medical treatment, and necropsy findings were retrieved from medical records. Outcome was obtained by reviewing performance, sales, and produce records or by telephone conversations with the owners. Results: Gastric outflow obstruction was treated by gastroduodenostomy or by gastrojejunostomy with or without jejunojejunostomy. Long-term follow-up was available for 36 of 39 foals that survived to hospital discharge; 25 (69%) survived >2 years. All 8 foals with pyloric obstruction survived >2 years, whereas only 11 of 21 (52%) foals with duodenal obstruction survived >2 years. Six of 8 foals with obstruction of the duodenum and pylorus survived >2 years. Obstruction of the duodenum, adhesions to the duodenum, and postoperative ileus were significantly associated with decreased long-term survival. Conclusions: Long-term outcome after gastric bypass procedures was substantially improved compared with previous reports. Factors that may have contributed to improved survival include better case selection and performing the gastrojejunostomy with the jejunum aligned from left to right. Conclusions: The prognosis for long-term survival after surgical bypass of pyloric obstruction is excellent. The overall prognosis for long-term survival after surgical bypass of duodenal obstruction is fair but should be considered guarded in those with pre-existing duodenal adhesions.
Publication Date: 2009-07-04 PubMed ID: 19573065DOI: 10.1111/j.1532-950X.2009.00539.xGoogle Scholar: Lookup
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- Journal Article
Summary
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The research discusses the outcomes of surgical treatment for gastric outflow obstruction in foals. It examines factors that influence the short- and long-term survival of the foals post-surgery.
Research Methodology
- The study was a case series involving 40 foals aged between 5 and 180 days.
- Data considered include clinical signs, lab reports, diagnostic imaging, surgical findings, surgical procedures, medical treatment, and autopsy findings. This information was obtained from the medical records of the foals.
- The study used sales records, productivity records, or telephonic conversations with the foals owners to ascertain the outcome.
Research Findings
- Gastric outflow obstruction was corrected via gastroduodenostomy or gastrojejunostomy, sometimes in conjunction with jejunojejunostomy.
- Of the initial 40 foals, 39 survived to the point of hospital discharge, and 36 of these had long-term follow-ups available. In general, there was a long-term survival rate of 69%, meaning 25 of the 36 foals survived for over 2 years.
- All foals that had pyloric obstruction survived beyond 2 years, while just over half (11 of 21) foals with duodenal obstruction achieved the same result. Among those with obstructions in both the duodenum and pylorus, 6 of 8 survived for more than 2 years.
- Obstruction of the duodenum, adherence to the duodenum, and postoperative ileus (a lack of bowel movement after surgery) were linked to a lower likelihood of long-term survival.
Research Conclusions and Implications
- The study found that gastric bypass procedures, when compared to previous data, showed significant improvements in long-term outcomes for foals. This may be due to better selection of cases or the method of performing the gastrojejunostomy (aligning the jejunum from left to right).
- Based on the findings, the researchers concluded that the prognosis for foals with pyloric obstruction undergoing surgical bypass is excellent in terms of long-term survival.
- However, the overall prognosis for long-term survival following surgical bypass for duodenal obstruction is only fair, and is considered guarded if there are pre-existing duodenal adhesions.
Cite This Article
APA
Zedler ST, Embertson RM, Bernard WV, Barr BS, Boston RC.
(2009).
Surgical treatment of gastric outflow obstruction in 40 foals.
Vet Surg, 38(5), 623-630.
https://doi.org/10.1111/j.1532-950X.2009.00539.x Publication
Researcher Affiliations
- Rood and Riddle Equine Hospital, Lexington, KY, USA. zedler@vet.upenn.edu
MeSH Terms
- Animals
- Animals, Suckling
- Gastric Bypass / adverse effects
- Gastric Bypass / methods
- Gastric Bypass / veterinary
- Gastric Outlet Obstruction / surgery
- Gastric Outlet Obstruction / veterinary
- Horse Diseases / surgery
- Horses
- Postoperative Complications / mortality
- Postoperative Complications / veterinary
- Risk Factors
Citations
This article has been cited 3 times.- Hewetson M, Tallon R. Equine Squamous Gastric Disease: Prevalence, Impact and Management. Vet Med (Auckl) 2021;12:381-399.
- Rowe JC, Huang AA, Heo J, Parnell NK, Rudinsky AJ. Benign Duodenal Stricture Treated with Surgical Correction and Dietary Therapy in a Golden Retriever. Case Rep Vet Med 2020;2020:4283175.
- Hewetson M, Venner M, Volquardsen J, Sykes BW, Hallowell GD, Vervuert I, Fosgate GT, Tulamo RM. Diagnostic accuracy of blood sucrose as a screening test for equine gastric ulcer syndrome (EGUS) in weanling foals. Acta Vet Scand 2018 Apr 13;60(1):24.
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