Use of digital abdominal radiography for the diagnosis of enterolithiasis in equids: 238 cases (2008–2011)

Maureen E. Kelleher William R. Pritchard Veterinary Medical Teaching Hospital, University of California-Davis, Davis, CA 95616.

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Sarah M. Puchalski Department of Surgical and Radiological Sciences, University of California-Davis, Davis, CA 95616.

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Christiana Drake School of Veterinary Medicine, and the Department of Statistics, College of Letters and Sciences, University of California-Davis, Davis, CA 95616.

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Sarah S. le Jeune Department of Surgical and Radiological Sciences, University of California-Davis, Davis, CA 95616.

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Abstract

Objective—To evaluate the sensitivity and specificity of direct digital abdominal radiography for the diagnosis of enterolithiasis in equids and to assess the effect of the number and anatomic location of enteroliths and gas distention of the gastrointestinal tract on diagnostic sensitivity of the technique.

Design—Retrospective case series.

Sample Population—238 horses and ponies ≥ 1 year old that underwent digital abdominal radiography with subsequent exploratory celiotomy or postmortem examination.

Procedures—For each case, 3 reviewers independently evaluated radiographic views. Radiographic images were evaluated for presence or absence and location of enteroliths and the degree of gas distention. Signalment, definitive diagnosis based on exploratory celiotomy or postmortem examination findings, and number and anatomic location of enteroliths were obtained from the medical records.

Results—70 of the 238 (29.4%) equids had confirmed enterolithiasis. With regard to diagnosis of enterolithiasis via digital radiography, overall sensitivity and specificity for the 3 reviewers were 84% and 96%, respectively. Sensitivity was lower for small colon enteroliths (61.5%) than for large colon enteroliths (88.9%) and was negatively affected by gas distention of the gastrointestinal tract. Sensitivity was not affected by the number of enteroliths.

Conclusions and Clinical Relevance—Sensitivity and specificity of digital radiography for the diagnosis of large colon enterolithiasis in equids was high. Sensitivity of digital radiography for detection of small colon enteroliths was lower than that for large colon enteroliths, but was higher than that typically associated with computed radiography. In geographic regions in which enterolithiasis in equids is endemic, digital abdominal radiography could be used as a diagnostic test for equids with colic.

Abstract

Objective—To evaluate the sensitivity and specificity of direct digital abdominal radiography for the diagnosis of enterolithiasis in equids and to assess the effect of the number and anatomic location of enteroliths and gas distention of the gastrointestinal tract on diagnostic sensitivity of the technique.

Design—Retrospective case series.

Sample Population—238 horses and ponies ≥ 1 year old that underwent digital abdominal radiography with subsequent exploratory celiotomy or postmortem examination.

Procedures—For each case, 3 reviewers independently evaluated radiographic views. Radiographic images were evaluated for presence or absence and location of enteroliths and the degree of gas distention. Signalment, definitive diagnosis based on exploratory celiotomy or postmortem examination findings, and number and anatomic location of enteroliths were obtained from the medical records.

Results—70 of the 238 (29.4%) equids had confirmed enterolithiasis. With regard to diagnosis of enterolithiasis via digital radiography, overall sensitivity and specificity for the 3 reviewers were 84% and 96%, respectively. Sensitivity was lower for small colon enteroliths (61.5%) than for large colon enteroliths (88.9%) and was negatively affected by gas distention of the gastrointestinal tract. Sensitivity was not affected by the number of enteroliths.

Conclusions and Clinical Relevance—Sensitivity and specificity of digital radiography for the diagnosis of large colon enterolithiasis in equids was high. Sensitivity of digital radiography for detection of small colon enteroliths was lower than that for large colon enteroliths, but was higher than that typically associated with computed radiography. In geographic regions in which enterolithiasis in equids is endemic, digital abdominal radiography could be used as a diagnostic test for equids with colic.

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