Intraluminal partial typhlectomy as therapy of non-reducible cecocolic intussusception

Abstract

Intraluminal partial typhlectomy as therapy of non-reducible cecocolic intussusceptionCecocolic intussusception is a rare pathologic lesion in horses and for a long time treatment of this disease was considered not to be successful. By now there are several descriptions of various surgical techniques with varying success rates. The purpose of this paper is to describe the surgical way of an intraluminal resection technique as a treatment of non-reducible cecocolic intussusception. Access to the cecum is obtained via a right high flank laparotomy. After preparation the intussusceptional cuff can be lifted into the laparotomy wound and the invaginated wall is cut off around the intussusceptional cuff. As a second step the amputated cecum will be removed from the exteriorized and enterotomied large colon. 20 out of 25 horses suffering from cecocolic intussusception underwent surgery over a period of 16 years. Ten horses were euthanized during surgery for different reasons. Surgery was finished in 10 horses, 8 horses recovered and were discharged from hospital. Two horses were euthanized following surgery {postoperative myopathy (1) and peritonitis/adhesion (1)}. In comparison to other techniques, surgical complications due to abdominal contamination, particularly peritonitis, are obvious.

Caecal intussusception in the horse: Ultrasonographic findings and survival to hospital discharge of 60 cases (2009–2013)

“…Despite inherent contamination, good results have been achieved (Wiemer and Van der Veen 1999;Hubert et al 2000;Gunnarsdottir et al 2011). Partial intraluminal typhlectomy has been developed as alternative necessitating a right flank approach and resection of the last rib with the horse in left lateral recumbency (Huskamp et al 2013).…”

“…Partial intraluminal typhlectomy has been developed as alternative necessitating a right flank approach and resection of the last rib with the horse in left lateral recumbency (Huskamp et al . ). Since caecocaecal intussusception appears to have a slightly better prognosis for long‐term survival (65–75%) than caecocolic intussusception (44–49%) (Martin et al .…”