FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / Equine Vet J / Use of a new device for inversion of the necrotic ileal stum...
Equine veterinary journal2023; doi: 10.1111/evj.13926

Use of a new device for inversion of the necrotic ileal stump in the caecum in four horses.

Abstract: In jejunocaecal anastomosis leaving a necrotic ileal stump has been implicated in complications and poor outcomes. Elective inversion of the necrotic stump using a nasogastric tube has been previously described, although this procedure can be cumbersome and can cause caecocolic orifice occlusion. Objective: To describe the use of a new device for elective inversion of necrotic ileal stumps. Methods: Case report. Methods: Details of the four horses that underwent intestinal resection and anastomosis with elective inversion of the ileal stump were retrieved from their medical records. For each case, a device was constructed by securing 0.7 m of hemp tape to a 0.5 m long electrical cable puller. The device was inserted into the ileum and passed through the caecum. The ileal lumen was closed using sutures or staples, and the tape was simultaneously secured to the intestine. The ileum was then resected. A small typhlotomy was performed at the proposed site for jejunocaecal anastomosis. The device was retrieved, the hemp tape was cut, and jejunocaecal anastomosis was completed. Results: The device was easily secured to the intestines. Small enterotomies were sufficient for device insertion and removal. In four clinical cases the procedure was effective in inverting the stump, and three out of the four horses recovered uneventfully and were discharged from the hospital. One horse was euthanised due to colic 27 months following discharge. Conclusions: Small number of cases admitted to single tertiary hospital. Conclusions: The device was effective in inverting the ileal stump in the included clinical cases. By leaving a short, inverted stump, this method may help improve the prognosis for jejunocaecal anastomosis, possibly avoiding certain undesired effects of the procedure. Further studies with large numbers of cases are required.
© 2023 EVJ Ltd.
Get Full Text
Publication Date: 2023-01-16 PubMed ID: 36645415DOI: 10.1111/evj.13926Google 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
  • Case Reports

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.

The study investigates the use of a custom-made device in performing an elective inversion of necrotic ileal stumps in horses during jejunocaecal anastomosis, a technique that effectively mitigated complications associated with leaving a necrotic stump post-surgery in four clinical cases.

Objective and Methodology of the Research

The study aimed to introduce a newly created device to perform an inversion of necrotic ileal stumps during jejunocaecal anastomosis in horses.

  • This was motivated by the understanding that leaving a necrotic ileal stump has been linked to post-surgical complications and poor performance outcomes.
  • A device was fashioned for each case by securing a 0.7m stretch of hemp tape to a 0.5m long electrical cable puller.
  • The device was introduced into the ileum and navigated through the caecum. Sutures or staples were used to close the ileal lumen while the tape was anchored to the intestine. Subsequently, the ileum was resected.
  • A minor typhlotomy was carried out at the would-be site for jejunocaecal anastomosis. The device was then salvaged, the hemp tape cut, and jejunocaecal anastomosis completed.
  • The process and outcome of the study were collated from the medical records of the four horses that had intestinal resection and anastomosis with elective inversion of the ileal stump.

Findings and Conclusion

The custom-made device was found to be effective in the elective inversion procedure, given:

  • The device was easily attached to the intestines, and small incisions were sufficient for its insertion and removal.
  • Out of the four treated horses, the procedure was successful in inverting the stump; three of the horses recovered without complications and were discharged from the hospital.
  • One horse was euthanized due to colic 27 months after being discharged.

The researchers concluded that the method implemented in this study may improve the prognosis associated with jejunocaecal anastomosis by avoiding some potentially negative effects. Nevertheless, they acknowledged the limitations of their study, including the small sample size and the focus on a single tertiary hospital. Consequently, they suggested further large-scale studies to fully ascertain the efficacy and potential advantages of this approach.

Cite This Article

APA
Gandini M, Giusto G. (2023). Use of a new device for inversion of the necrotic ileal stump in the caecum in four horses. Equine Vet J. https://doi.org/10.1111/evj.13926

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.
Giusto, Gessica
  • Department of Veterinary Sciences, University of Turin, Turin, Italy.

References

This article includes 24 references
  1. Rudnick MJ, Denagamage TN, Freeman DE. Effects of age, disease and anastomosis on short- and long-term survival after surgical correction of small intestinal strangulating diseases in 89 horses.. Equine Vet J 2022;54(6):1031-8.
    doi: 10.1111/evj.13558google scholar: lookup
  2. Freeman DE, Schaeffer DJ. Comparison of complications and long-term survival rates following hand-sewn versus stapled side-to-side jejunocecostomy in horses with colic.. J Am Vet Med Assoc 2010;237(9):1060-7.
  3. Freeman DE, Hammock P, Baker GJ, Goetz T, Foreman JH, Schaffer DJ. Short- and long-term survival and prevalence of postoperative ileus after small intestinal surgery in the horse.. Equine Vet J 2000;32(S32):42-51.
  4. Proudman CJ, Edwards GB, Barnes J. Differential survival in horses requiring end-to-end jejunojejunal anastomosis compared to those requiring side-to-side jejunocaecal anastomosis.. Equine Vet J 2007;39(2):181-5.
  5. Stewart S, Southwood LL, Aceto HW. Comparison of short- and long-term complications and survival following jejunojejunostomy, jejunoileostomy and jejunocaecostomy in 112 horses: 2005-2010.. Equine Vet J 2014;46(3):333-8.
  6. Brown JA, Holcombe SJ, Southwood LL, Byron CR, Embertson RM, Hauptmann JG. End-to-side versus side-to-side jejunocecostomy in horses: a retrospective analysis of 150 cases.. Vet Surg 2015;44(4):527-33.
  7. Gandini M, Giusto G, Iotti B, Valazza A, Sammartano F. In vitro description of a new technique for stapled side-to-side jejunocecal anastomosis in horses and CT scan anatomical comparison with other techniques.. BMC Vet Res 2014;10(S1):S9.
  8. Pankowski RL. Small intestinal surgery in the horse: a review of ileo and jejunocecostomy.. J Am Vet Med Assoc 1987;190:1608.
  9. Donawick WJ, Christie BA, Stewart JV. Resection of diseased ileum in the horse.. J Am Vet Med Assoc 1971;159(9):1146-9.
  10. Ducharme NG, Hackett RP, Ducharme GR, Long S. Surgical treatment of colic-results in 181 horses.. Vet Surg 1983;12:206-9.
  11. Bladon BM, Hillyer MH. Effect of extensive ileal resection with a large resulting mesenteric defect and stapled ileal stump in horses with a jejunocaecostomy: a comparison with other anastomotic techniques.. Equine Vet J 2000;32(S32):52-8.
  12. Freeman DE. Chapter 30, small intestinal resection and anastomosis.. 2009;p. 532-3.
  13. Schumacher J, Hanrahan L. Ileocecocolic intussusception as a sequel to jejunocecostomy in a mare.. J Am Vet Med Assoc 1987;190(3):303-4.
  14. Edwards GB. Resection and anastomosis of small intestine: current methods applicable to the horse.. Equine Vet J 1986;18(4):322-30.
  15. Edwards GB. Obstruction of the ileum in the horse: a report of 27 clinical cases.. Equine Vet J 1981;13:158-66.
  16. Vasey JR, Julian RJ. Elective inversion of the distal ileal stump into the caecum of the horse.. Equine Vet J 1987;19(3):223-5.
  17. Freeman DE, Schaeffer DJ, Cleary OB. Long-term survival in horses with strangulating obstruction of the small intestine managed without resection.. Equine Vet J 2014;46(6):711-7.
  18. Freeman DE, Schaeffer DJ. Short-term survival after surgery for epiploic foramen entrapment compared with other strangulating diseases of the small intestine in horses.. Equine Vet J 2005;37(4):292-5.
  19. Gandini M. Handsewn semiclosed single-layer jejunocecal side-to-side anastomosis in the horse.. Vet Surg 2010;39(6):771-5.
  20. Giusto G, Pagliara E, Gandini M. Effects of bit chewing on right upper quadrant intestinal sound frequency in adult horses.. J Equine Vet Sci 2014;34:520-3.
  21. Patton ME, Leise BS, Baker RE, Andrews FM. The effects of bit chewing on borborygmi, duodenal motility, and gastrointestinal transit time in clinically normal horses.. Vet Surg 2022;51(1):88-96.
  22. Erkert RS, Crowson LC, Moll D, Bentz BG, Confer AW, Blaik MA. Obstruction of the caecocolic orifice by ileocecocolic intussusception following jejunocecostomy in a horse.. J Am Vet Med Assoc 2003;12:1743-5.
  23. Espinosa P, Le Jeune SS, Cenani A, Kass PH, Brosnan RJ. Investigation of perioperative and anesthetic variables affecting short-term survival of horses with small intestinal strangulating lesions.. Vet Surg 2017;46(3):345-53.
  24. Nakayama S, Hasegawa S, Nagayama S, Kato S, Hida K, Tanaka E. The importance of precompression time for secure stapling with a linear stapler.. Surg Endosc 2011;25(7):2382-6.

Citations

This article has been cited 0 times.
Subscribe to our newsletter
Join 99,357 horse owners like you who receive our email updates on horse health and nutrition.