Use of pelvic flexure biopsies to predict survival after large colon torsion in horses.
Abstract: To determine if morphologic evaluation of intraoperative biopsies of the large colon could be used to accurately predict outcome in horses with large colon torsion. Methods: Clinical study. Methods: Fifty-four horses with large colon torsion. Methods: A full-thickness biopsy was collected from the pelvic flexure of the ascending colon after correction of naturally occurring colonic torsion. Morphologic changes were evaluated and graded for interstitial tissue to crypt ratio (I:C ratio), percentage loss of superficial and glandular epithelium, and the degree of hemorrhage and edema. These variables were then used to predict survival. Results: Morphologic variables could be used to correctly predict survival or death in 51 horses (P < .0001). This corresponded to a sensitivity of 95.1% (82.2%-99.2%; 95% CI) and a specificity of 92.3% (62.0%-99.6%; 95% CI). Of 6 horses that had colonic resection, 5 survived; an accurate prediction of outcome based on morphologic criteria was made for each horse. Conclusions: Interpretation of changes in colonic morphology can be used to accurately predict postoperative survival in horses with large colon torsion. Conclusions: Use of frozen colonic tissue sections is a rapid, reliable, and relatively inexpensive method for assessing morphologic damage associated with large colon torsion during surgery. Intraoperative evaluation of pelvic flexure biopsies can aid in the prediction of survival and guide surgical judgment as to the need for colonic resection.
Publication Date: 2000-12-01 PubMed ID: 11098791DOI: 10.1053/jvet.2000.17836Google Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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The study investigated if using biopsies from the colon could accurately predict survival outcomes for horses suffering from a large colon twist condition. It used various morphologic factors, such as tissue to crypt ratio and loss of superficial epithelium, as indicators to predict the survival of the horses.
Research Methodology
- The research involved 54 horses that had large colon torsion—a condition where the horse’s colon twists onto itself, creating a blockage.
- During corrective procedures, researchers collected a full-thickness biopsy from the pelvic flexure area of the ascending colon.
- The biopsies were analyzed, focusing on morphologic changes. Key assessment areas included: the ratio of interstitial tissue to crypt (structural cavities of the colon), the percentage of loss of superficial and glandular epithelium, and the degree of hemorrhage and edema (swelling caused by fluid accumulation).
- These characteristics were used to predict survival outcomes.
Research Findings
- The results pointed out that morphologic variables could correctly predict survival or death in 51 out of the 54 horses. This precision corresponds to a sensitivity rate of 95.1% and a specificity rate of 92.3%.
- Additionally, out of the 6 horses that underwent colonic resection, 5 of them survived—a result that aligned with predictions based on morphologic criteria.
Conclusions
- The findings prove that changes in colonic morphology can be used to accurately predict postoperative survival in horses subjected to a large colon torsion.
- According to the study, the application of frozen colonic tissue sections provides a rapid, reliable, and relatively inexpensive process for assessing morphologic damage corresponding to large colon torsion during surgical procedures.
- The intraoperative evaluation of pelvic flexure biopsies offers a predictive tool for survival outcomes and can guide surgical decisions concerning the necessity of colonic resection.
Cite This Article
APA
Van Hoogmoed L, Snyder JR, Pascoe JR, Olander H.
(2000).
Use of pelvic flexure biopsies to predict survival after large colon torsion in horses.
Vet Surg, 29(6), 572-577.
https://doi.org/10.1053/jvet.2000.17836 Publication
Researcher Affiliations
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis 95616, USA.
MeSH Terms
- Animals
- Biopsy / veterinary
- Colon / blood supply
- Colon / pathology
- Colonic Pseudo-Obstruction / mortality
- Colonic Pseudo-Obstruction / pathology
- Colonic Pseudo-Obstruction / surgery
- Colonic Pseudo-Obstruction / veterinary
- Horse Diseases / mortality
- Horse Diseases / pathology
- Horse Diseases / surgery
- Horses
- Intraoperative Period
- Prognosis
- Records / veterinary
- Regional Blood Flow
- Survival Analysis
- Torsion Abnormality / veterinary
- Treatment Outcome
Citations
This article has been cited 8 times.- Lambertini C, Zannoni A, Romagnoli N, Bombardi C, Morini M, Dondi F, Bernardini C, Forni M, Rinnovati R, Spadari A. Expression of Proteinase-Activated Receptor 2 During Colon Volvulus in the Horse.. Front Vet Sci 2020;7:589367.
- Gonzalez LM, Baker WT, Hughes FE, Blikslager AT, Fogle CA. Comparison of histomorphometric characteristics of dorsal colon and pelvic flexure biopsy specimens obtained from horses with large colon volvulus that underwent resection.. Am J Vet Res 2020 Nov;81(11):899-903.
- Lambertini C, Bombardi C, Zannoni A, Bernardini C, Dondi F, Morini M, Rinnovati R, Spadari A, Romagnoli N. Proteinase Activated Receptor 4 in the Jejunum of Healthy Horses and of Horses With Epiploic Hernia.. Front Vet Sci 2020;7:158.
- Orr KE, Baker WT, Lynch TM, Hughes FE, Clark CK, Slone DE Jr, Fogle CA, Gonzalez LM. Prognostic value of colonic and peripheral venous lactate measurements in horses with large colon volvulus.. Vet Surg 2020 Apr;49(3):472-479.
- Blikslager A, Gonzalez L. Equine Intestinal Mucosal Pathobiology.. Annu Rev Anim Biosci 2018 Feb 15;6:157-175.
- Kucera CR, Stranahan LW, Hughes F, Blikslager AT, Gonzalez LM. Protein biomarker of cell proliferation determines survival to discharge in cases of equine large colon volvulus.. Equine Vet J 2018 Jul;50(4):452-456.
- Gonzalez LM, Kinnin LA, Blikslager AT. Characterization of discrete equine intestinal epithelial cell lineages.. Am J Vet Res 2015 Apr;76(4):358-66.
- Gonzalez LM, Fogle CA, Baker WT, Hughes FE, Law JM, Motsinger-Reif AA, Blikslager AT. Operative factors associated with short-term outcome in horses with large colon volvulus: 47 cases from 2006 to 2013.. Equine Vet J 2015 May;47(3):279-84.
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