Surgical management of small intestinal incarceration through the gastrosplenic ligament: 14 cases (1994–2006)

Thomas M. Jenei Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.

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José M. García-López Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.

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Patricia J. Provost Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.

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Carl A. Kirker-Head Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.

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Abstract

Objective—To determine prevalence, clinical findings, and long-term survival rate after surgery associated with incarceration of the small intestine through the gastrosplenic ligament (ISIGL) in horses.

Design—Retrospective case series.

Animals—14 horses with ISIGL.

Procedures—Medical records of horses with ISIGL examined between January 1994 and December 2006 were reviewed. Signalment, initial physical examination findings, results of abdominal fluid analysis, and clinical laboratory values were recorded, along with surgical findings, including segment of incarcerated intestine and surgical procedures performed. Long-term survival data were obtained through client interviews.

Results—Clinical findings included small intestinal distention identified via rectal palpation (10/14 horses) or transabdominal ultrasonography (8/11), nasogastric reflux (4/14), and abnormal abdominal fluid (9/9). All horses required intestinal resection and anastomosis. Postoperative complications included adynamic ileus (5/14 horses), incisional infection (4/14), diarrhea (3/14), and laminitis (1/14). No breed or age predilection was detected, although geldings were at increased risk for ISIGL. Long-term survival rate was 79% (11/14 horses).

Conclusions and Clinical Relevance—ISIGL was an uncommon cause of colicin this hospital population. With appropriate surgical intervention and postoperative management, the long-term prognosis for surgically treated horses was fair to good.

Abstract

Objective—To determine prevalence, clinical findings, and long-term survival rate after surgery associated with incarceration of the small intestine through the gastrosplenic ligament (ISIGL) in horses.

Design—Retrospective case series.

Animals—14 horses with ISIGL.

Procedures—Medical records of horses with ISIGL examined between January 1994 and December 2006 were reviewed. Signalment, initial physical examination findings, results of abdominal fluid analysis, and clinical laboratory values were recorded, along with surgical findings, including segment of incarcerated intestine and surgical procedures performed. Long-term survival data were obtained through client interviews.

Results—Clinical findings included small intestinal distention identified via rectal palpation (10/14 horses) or transabdominal ultrasonography (8/11), nasogastric reflux (4/14), and abnormal abdominal fluid (9/9). All horses required intestinal resection and anastomosis. Postoperative complications included adynamic ileus (5/14 horses), incisional infection (4/14), diarrhea (3/14), and laminitis (1/14). No breed or age predilection was detected, although geldings were at increased risk for ISIGL. Long-term survival rate was 79% (11/14 horses).

Conclusions and Clinical Relevance—ISIGL was an uncommon cause of colicin this hospital population. With appropriate surgical intervention and postoperative management, the long-term prognosis for surgically treated horses was fair to good.

Contributor Notes

The authors thank Beth Mellor for assistance with line drawings.

Address correspondence to Dr. Jenei.
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