Transection of the pelvic flexure to reduce incarceration of the large colon through the epiploic foramen in a horse.

The study reports a case where a 7-year-old Thoroughbred mare underwent a surgical procedure to manage colic caused by a large colon trapped in the epiploic foramen, a hernia situation. The surgeons cut the pelvic flexure and sealed the ends of the large colon, moved healthy left ventral colon to provide space, reduced the herniated organ, resected diseased parts, and finally rejoined the colons using an end-to-end anastomosis.

Introduction and Objective

• This paper presents the surgical procedure performed on a Thoroughbred mare that was suffering from colic caused by a herniated large colon.
• The herniation was irreducible, meaning it could not be pushed back, and located through the epiploic foramen, a space in the horse’s abdominal cavity that can sometimes allow structures to slip through, causing hernias.
• The objective of the research was to describe the step-by-step surgical procedure carried out to alleviate the hernia and treat colic in the mare.

Procedure Explained

• The initial step of the procedure was the transection of the pelvic flexure. This means the surgeons made a transverse cut in the pelvic flexure of the large colon. This process facilitates the manipulation and reduction of the hernia.
• The ends of the large colon, after transection, were closed as part of preparing the colon for repositioning.
• The intercolonic mesentery was then divided, effectively disconnecting the two parts of the large colon.
• The unaffected left ventral colon, which was not herniated, was relocated into the epiploic foramen. This action provided enough space so the herniated, or affected part of the left dorsal colon, could be reduced, or placed back in the normal position.

Disease Management and Final Steps

• After reducing the affected left ventral colon, the surgeons then removed the diseased sections of both colons – a process known as resection.
• At this point, the colons were separated, and to restore the regular digestive function, the two parts of the colon were reconnected in an end-to-end anastomosis. An anastomosis is a surgical procedure involving the connection of two body channels, such as blood vessels or loops of intestine.
• The paper variably does not provide results or prognosis after the surgical intervention. However, the documentation of this procedure may serve as a reference for similar cases involving horses in the future.