Surgery: Short‐ and long‐term evaluation of surgical treatment of strangulating obstructions of the small intestine in horses: A review of 224 cases

Abstract

SUMMARYA retrospective study was carried out of 224 horses operated for strangulating small intestine obstructions. Fiftyfour horses were euthanized and 5 horses died during surgery which means that 165 (73%) were allowed to recover. Of these, 53 horses were euthanized or died in the clinic and 112 (50%) were discharged from the hospital. Of 90 horses available for follow-up 1 year postoperatively, 76 (84%) were still alive. The most important causes of death or reasons for euthanasia in the direct post-operative period were post-operative paralytic ileus, (adhesive) peritonitis and intra-abdominal haemorrhage. After discharge from the hospital the reasons were (adhesive) peritonitis and (recurrent) colic. Of the horses which survived for at least 1 year, 16% sometimes suffered from colic, 12% experienced problems with incisional woundhealing and 4% suffered from jugular vein thrombosis. All were in good or reasonable condition and 88% performed at (approximately) the same level as before the operation. The type of surgical intervention (i.e. enterotomy, enterectomy) did not significantly influence the outcome of surgery, whereas the type of anastomosis did. End-to-end jejunojejunostomy had a better prognosis than side-toside jejunocaecostomy.It was concluded that strangulating obstructions of the small intestine still carry a poor to guarded prognosis.Mortality was highest in the direct peri-operative period.Once discharged from hospital, prognosis can be considered to be fair to good. Attempts to improve outcome should be directed at a better handling of the ileal stump during surgery and at the prevention of post-operative ileus and the formation of adhesions.

A report of left dorsal displacement of the large colon in a tropical horse

“…The outcome and prognosis for horses after surgery for colic can be difficult to predict and is highly dependent on the nature and severity of the lesion [12] . To our knowledge, few studies report outcome in horses with left dorsal large colon volvulus (defined as volvulus unrelated to other apparent causes like incarceration, lipoma, mesenteric rent, etc.).…”

“…A national survey reported colic as a leading health concern and a major cause of death in horses [9][10][11] . Strangulating largecolon volvulus can account for 11% to 27% of surgical cases of colic [ and fatality of affected horses can approach 34% to 65.3% without resection [1,12] . The absolute twist of the intestine around the mesenteric attachment is named volvulus.…”

Perfil e distribuição da síndrome cólica em eqüinos em três unidades militares do Estado do Rio de Janeiro, Brasil

“…A reincidência foi elevada, tendo sido maior no REsC (62,5%), quando comparado à AMAN (36,7%) e ao EEC (29,0%). É comum a reincidência (COHEN et al, 1995;COHEN & PELOSO, 1996;REEVES et al, 1996;TINKER et al, 1997a,b;TRAUB-DARGATZ et al, 2001; VAN DEN BOOM & VAN DER VELDEN, 2001). Os resultados do presente estudo sinalizam que medidas para redução da incidência de cólica ou não estão sendo tomadas ou, se adotadas, são ineficazes, principalmente no RESC, - Apenas três equinos (0,33%) foram submetidos à cirurgia em decorrência de cólica, sendo estes pertencentes à AMAN, representando 6,5% dos equinos que apresentaram cólica nessa unidade e 0,7% do total de equinos acometidos nas três unidades.…”

“…Equinos com histórico de cólica apresentam risco 3,6 vezes maior de reincidência (TINKER et al, 1997b). TRAUB-DARGATZ et al (2001) detectaram 11% de reincidência em animais acompanhados por um ano e VAN DEN BOOM & VAN DER VELDEN (2001) observaram reincidência em 16% dos equinos submetidos a cirurgias abdominais. O histórico de episódio anterior de cólica não ajuda a identificar o mecanismo patofisiológico da cólica e também não é um fator de risco que possa ser alterado.…”

Peritoneal Response to Abdominal Surgery: The Role of Equine Abdominal Adhesions and Current Prophylactic Strategies

“…Omentectomy's influence on adhesion formation has been investigated in horses [35, 36]. Omentum removal results in decreased adhesion formation and facilitates postoperative peritoneal lavage [37, 38].…”