Grade IV gastric ulceration, pyloric aplasia, and an ectopic duodenal papilla in a 13-year-old Quarter Horse gelding evaluated for recurrent colic

Charlotte K. Barton Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO

Search for other papers by Charlotte K. Barton in
Current site
Google Scholar
PubMed
Close
 BVetMed, MS https://orcid.org/0000-0003-4493-8888
,
Alex True Littleton Equine Medical Center, Littleton, CO

Search for other papers by Alex True in
Current site
Google Scholar
PubMed
Close
 DVM
,
Melissa Fenn Littleton Equine Medical Center, Littleton, CO

Search for other papers by Melissa Fenn in
Current site
Google Scholar
PubMed
Close
 DVM, MS, DACVIM
,
Parvathy Thampi Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO

Search for other papers by Parvathy Thampi in
Current site
Google Scholar
PubMed
Close
 PhD
,
Allison Watson Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO

Search for other papers by Allison Watson in
Current site
Google Scholar
PubMed
Close
 DVM, DACVP
, and
Lauren E. Smanik Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO

Search for other papers by Lauren E. Smanik in
Current site
Google Scholar
PubMed
Close
 DVM, MS, DACVS https://orcid.org/0000-0001-7226-5807

Abstract

OBJECTIVE

The objective of this Case Report was to describe the clinical manifestation and postmortem findings of a horse evaluated for recurrent colic diagnosed with pyloric aplasia and an ectopic duodenal papilla.

ANIMAL

13-year-old Quarter Horse gelding.

CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES

The horse was presented to a referral center for signs of colic that were unresponsive to management on the farm. No abnormalities were noted on rectal palpation; however, upon passage of a nasogastric tube, 31 L of net gastric reflux was obtained. Gastroscopy noted grade IV squamous ulceration and moderate glandular ulceration, severe gastric dilatation, an abnormally positioned gastric outflow tract, and an ectopic duodenal papilla leaking bile-like fluid directly into the stomach.

TREATMENT AND OUTCOME

The horse was initially treated with gastroprotectants, promotility agents, and dietary modifications. Following treatment failure and repeated episodes of colic with increasing severity, the horse was euthanized and a necropsy performed. At necropsy, it was confirmed that the aboral aspect of the stomach formed a dilated pouch and continued directly into the proximal duodenum with no discernible pyloric sphincter. The area of the pylorus was delineated by a faint indentation. The ectopic duodenal papilla was traced to the liver.

CLINICAL RELEVANCE

Congenital gastric abnormalities, even in adult horses, should be considered as differential diagnoses when investigating horses presenting with a history of chronic colic. Neither pyloric aplasia nor an ectopic duodenal papilla have been described in the equine literature, and this Case Report raises awareness of the presence of such malformations and their manifestations.

Abstract

OBJECTIVE

The objective of this Case Report was to describe the clinical manifestation and postmortem findings of a horse evaluated for recurrent colic diagnosed with pyloric aplasia and an ectopic duodenal papilla.

ANIMAL

13-year-old Quarter Horse gelding.

CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES

The horse was presented to a referral center for signs of colic that were unresponsive to management on the farm. No abnormalities were noted on rectal palpation; however, upon passage of a nasogastric tube, 31 L of net gastric reflux was obtained. Gastroscopy noted grade IV squamous ulceration and moderate glandular ulceration, severe gastric dilatation, an abnormally positioned gastric outflow tract, and an ectopic duodenal papilla leaking bile-like fluid directly into the stomach.

TREATMENT AND OUTCOME

The horse was initially treated with gastroprotectants, promotility agents, and dietary modifications. Following treatment failure and repeated episodes of colic with increasing severity, the horse was euthanized and a necropsy performed. At necropsy, it was confirmed that the aboral aspect of the stomach formed a dilated pouch and continued directly into the proximal duodenum with no discernible pyloric sphincter. The area of the pylorus was delineated by a faint indentation. The ectopic duodenal papilla was traced to the liver.

CLINICAL RELEVANCE

Congenital gastric abnormalities, even in adult horses, should be considered as differential diagnoses when investigating horses presenting with a history of chronic colic. Neither pyloric aplasia nor an ectopic duodenal papilla have been described in the equine literature, and this Case Report raises awareness of the presence of such malformations and their manifestations.

All Time Past Year Past 30 Days
Abstract Views 219 219 95
Full Text Views 26 26 11
PDF Downloads 31 31 14
Advertisement