Use of a modified Roux-en-Y procedure for treatment of pyloroduodenal obstruction in a horse.

This research discusses the successful treatment of a blockage in the stomach and initial part of the small intestine (pyloroduodenal obstruction) of a horse using a modified Roux-en-Y surgical procedure.

The Health Problem of the Horse

• The researchers looked at a twelve-year-old Arabian stallion suffering from a four-week progression of symptoms indicating intestinal obstruction. These symptoms included swelling in the belly and hind legs (ventral and hind limb edema), low protein levels in the blood (hypoproteinemia), presence of hidden blood in feces (fecal occult blood), occasional abdominal pain, weight loss, and backward flow of gastric contents (gastric reflux).

Diagnosis and Treatment Decision

• Upon further investigation of the horse’s condition through an exploratory surgical procedure known as celiotomy, it was discovered that there was a blockage (obstructive mass) situated in the stomach’s exit (pylorus) and the beginning part of the small intestine (duodenum).
• Due to the inaccessibility of the blocked site, it was not possible to remove (resect) the problematic area. Thus, the decision was made to bypass the blockage using a modified Roux-en-Y procedure.

The Roux-en-Y Procedure with Modifications

• The adopted surgical procedure involved creating a new pathway for the food to pass by connecting the stomach (gastrojejunostomy) and the duodenum (duodenojejunostomy) directly to the jejunum (a part of the small intestine).
• For these connections (anastomoses), the surgeons chose to use stapled side-to-side anastomosis techniques. This particular technique involves using surgical staples to attach two sections of the intestine side-by-side, thus forming a passage between them.

Overall, the research introduces a successfully applied modified Roux-en-Y procedure for managing a hard-to-reach pyloroduodenal obstruction in a horse. The case is discussed in the context of integrating it into the broader approaches of equine veterinary surgery.