Incarceration of the small intestine by the epiploic foramen in fifteen horses.

Abstract

In 15 horses with acute abdominal disease, a diagnosis of incarceration of small intestine through the epiploic foramen was made, either at the time of exploratory celiotomy or at necropsy.The horses exhibited signs of moderate to severe abdominal pain and were suffering from hypovolaemic and/or endotoxic shock. Nasogastric intubation produced either gas or fluid, the pH of which was in the range of 5 to 7.2, indicating reflux of small intestinal content into the stomach. Consistent physical findings included absence of gut sounds on auscultation, dilated small intestine palpable on rectal examination, and serosanguineous or xanthochromic fluid from abdominal paracentesis.A ventral midline laparotomy was performed on 11 horses. The incarcerated bowel, which involved the distal jejunum and ileum in 14 horses and jejunum in one horse, varied in length from 26 cm to 13 meters. Reduction of the incarceration was accomplished by gentle traction of the efferent and/or afferent intestine. Infarcted segments of the small intestine were exteriorized, resected, and an end-to-end jejunal anastomosis or an end-to-side jejunocecal anastomosis was performed. A successful postoperative recovery was achieved in three horses.