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Small Intestine Resection and Anastomosis for Epiploic Foramen Entrapment of a Horse

말의 그물막구멍포착 교정을 위한 소장 절제 및 문합 1례

  • Accepted : 2014.08.18
  • Published : 2015.08.31

Abstract

A 10-year-old gelding Warmblood weighing 560 kg was referred to J&C Equine Hospital with the history of hyperpnea, depression, pawing, and rolling for 7 hours. According to the results of clinical and ultrasound examination, it was considered that intestines were distended with thickened wall. The horse had been treated with lactated Ringers' solution (14 L, IV), flunixin meglumine (1.1 mg/kg, IV), and mineral oil (1 L, PO), but he did not show any responses to those treatments. Exploratory laparotomy was performed and identified incarcerated small intestine through the epiploic foramen. The horse received resection and anastomosis of the entrapped small intestine. After surgery, the horse was treated with intensive postoperative care of fluid therapy (5 L with 20 mEq/L KCl, every 2 hours), flunixin meglumine (1.1 mg/kg, IV, sid), antibiotics (penicillin 22,000 IU/kg, IV, qid and gentamicin 6.6 mg/kg, IV, sid), lidocaine constant rate infusion (bolus 1.3 mg/kg over 15 minutes then 0.05 mg/kg/minute), common nutritional supplements, nasogastric intubation every 2 hours and trunk bandage. Postoperative feeding program had started with small amount of hay every 4 hours and gradually increased to normal amount till 5 days. At 77 days after surgery, he showed sudden outbreak of colic and was euthanized. The causes of colic were small intestinal strangulation by passing through the mesenteric rents and postoperative adhesion between small intestines. According to the results, it is recommended to perform perioperative intensive care of horse with colic and to use several methods to prevent adhesions during abdominal surgery of horses.

Keywords

References

  1. Archer DC, Pinchbeck GK, French NP, Proudman CJ. Risk factors for epiploic foramen entrapment colic - an international study. Equine Vet J 2008; 40: 224-230. https://doi.org/10.2746/042516408X266079
  2. Archer DC, Freeman DE, Doyle AJ, Proudman CJ, Edwards GB. Association between cribbing and entrapment of the small intestine in the epiploic foramen in horses: 68 cases (1991-2002). J Am Vet Med Assoc 2004; 224: 562-564. https://doi.org/10.2460/javma.2004.224.562
  3. Archer DC, Proudman CJ, Pinchbeck G, Smith JE, French NP, Edwards GB. Entrapment of the small intestine in the epiploic foramen in horses - a retrospective analysis of 71 cases recorded between 1991 and 2001. Vet Rec 2004; 155: 793-797.
  4. Baxter GM, Broome TE, Moore JN. Abdominal adhesions after small intestinal surgery in the horse. Vet Surg 1989; 18: 409-414.
  5. Becker JM, Dayton MT, Fazio VW, Beck DE, Stryker SJ, Wexner SD, Wolff BG, Roberts PL, Smith LE, Sweeney SA, Moore M. Prevention of postoperative abdominal adhesions by a sodium hyaluronate-based bioresorbable membrane: a prospective, randomized, double-blind multicenter study. J Am Coll Surg 1996; 183: 297-306.
  6. Davis DM, McClure JR, Bertone AL, Cazayoux CA, Vice JD. Hypoglycemia and hepatic necrosis after small intestinal incarceration through the epiploic foramen in a horse. Cornell Vet 1992; 82: 173-179.
  7. Engelbert TA, Tate LP Jr, Bowman KF, Bristol DG. Incarceration of the small intestine in the epiploic foramen - report of 19 cases (1983-1992). Vet Surg 1993; 22: 57-61. https://doi.org/10.1111/j.1532-950X.1993.tb00370.x
  8. Fogle CA, Gerard MP, Elce YA, Little D, Morton AJ, Correa MT, Blikslager AT. Analysis of sodium carboxymethylcellulose administration and related factors associated with postoperative colic and survival in horses with small intestinal disease. Vet Surg 2008; 37: 558-563. https://doi.org/10.1111/j.1532-950X.2008.00420.x
  9. Freeman DE. Diseases of the small intestine. In: The equine acute abdomen. Wyoming: Teton NewMedia. 2008: 593-616.
  10. Freeman DE. Small intestine. In: Equine surgery, 4th ed. St. Louis: Saunders. 2012: 416-453.
  11. Freeman DE. Surgery of the small intestine. Vet Clin North Am Equine Pract1997; 13: 261-301. https://doi.org/10.1016/S0749-0739(17)30240-7
  12. 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: 292-295.
  13. Freeman DE, Hammock P, Baker GJ. Short- and long-term survival and prevalence of postoperative ileus after small intestinal surgery in the horse. Equine Vet J 2000; 32: 42-51.
  14. Hutchins DR, Rawlinson RJ. Eventration as a sequel to castration of the horse. Aust Vet J 1972; 48: 288-291. https://doi.org/10.1111/j.1751-0813.1972.tb05159.x
  15. Klohnen A, Vachon AM, Fischer AT Jr. Use of diagnostic ultrasonography in horses with signs of acute abdominal pain. J Am Vet Med Assoc 1996; 209: 1597-1601.
  16. Livesey MA, Little CB, Boyd C. Fatal hemorrhage associated with incarceration of small intestine by the epiploic foramen in three horses. Can Vet J 1991; 32: 434-436.
  17. MacDonald MH, Pascoe JR, Stover SM, Meagher DM. Survival after small intestine resection and anastomosis in horses. Vet Surg 1989; 18: 415-423.
  18. Morton AJ, Blikslager AT. Surgical and postoperative factors influencing short-term survival of horses following small intestinal resection - 92 cases (1994-2001). Equine Vet J 2002; 34: 450-454.
  19. Phillips TJ, Walmsley JP. Retrospective analysis of the results of 151 exploratory laparotomies in horses with gastrointestinal disease. Equine Vet J 1993; 25: 427-431. https://doi.org/10.1111/j.2042-3306.1993.tb02985.x
  20. Sanchez LC. Disorders of the gastrointestinal system. In: Equine internal medicine, 3rd ed. St. Louis: Saunders. 2010: 777-938.
  21. Southwood LL. Specific causes of colic. In: Practical guide to equine colic. Iowa: Wiley-Blackwell. 2013: 204-229.
  22. Turner TA, Adams SB, White NA. Small intestine incarceration through the epiploic foramen of the horse. J Am Vet Med Assoc 1984; 184: 731-734.
  23. Vachon AM, Fischer AT. Small intestinal herniation through the epiploic foramen: 53 cases (1987-1993). Equine Vet J 1995; 27: 373-380. https://doi.org/10.1111/j.2042-3306.1995.tb04073.x
  24. Vasey JR. Incarceration of the small intestine by the epiploic foramen in fifteen horses. Can Vet J 1988; 29: 378-382.