ABSTRACT
We report one such case which was diagnosed intraoperatively as left dorsal colon volvulus due to multiple mesenteric abnormalities. A 17-year-old castrated male horse was taken to the Tehran University Veterinary Hospital for treatment of metacarpal wound accompanied by severe abdominal distension and acute colic. The treatment and measurement were taken for a month, and the prepared biopsy indicated that the healing trend was obvious. Unfortunately, prior to discharge, the clinical colic manifestations emerged and the animal suddenly died. Dilated large intestine was palpated per rectum and a ventral midline exploratory laparotomy was performed, a complete volvulus of the ascending colon was identified with multiple mesenteric anomalies of unknown aetiology. The pathologic changes observed in this study accurately reflect those changes reported in horse with naturally occurring colonic volvulus and can serve as a reference for subsequent studies on attenuating bowel injury. The present study results can be used to make a scientific assessment of prognosis in the pre-operative, operative, and post-operative management of horses with large colon volvulus.
ABSTRACT
We report one such case which was diagnosed intraoperatively as left dorsal colon volvulus due to multiple mesenteric abnormalities. A 17-year-old castrated male horse was taken to the Tehran University Veterinary Hospital for treatment of metacarpal wound accompanied by severe abdominal distension and acute colic. The treatment and measurement were taken for a month, and the prepared biopsy indicated that the healing trend was obvious. Unfortunately, prior to discharge, the clinical colic manifestations emerged and the animal suddenly died. Dilated large intestine was palpated per rectum and a ventral midline exploratory laparotomy was performed, a complete volvulus of the ascending colon was identified with multiple mesenteric anomalies of unknown aetiology. The pathologic changes observed in this study accurately reflect those changes reported in horse with naturally occurring colonic volvulus and can serve as a reference for subsequent studies on attenuating bowel injury. The present study results can be used to make a scientific assessment of prognosis in the pre-operative, operative, and post-operative management of horses with large colon volvulus.
Subject(s)
Animals , Male , Colon , Pathology , Colonic Diseases , Fatal Outcome , Horse Diseases , Diagnosis , Pathology , HorsesABSTRACT
La obstrucción estrangulante es la combinación de obstrucción simple del tracto gastrointestinal del equino acompañado de bloqueo del abastecimiento circulatorio, lo cual causa severa enfermedad intestinal. Esta afección es comúnmente conocida como Síndrome Abdominal Agudo o Cólico. La incidencia de esta afección es considerada baja con una mortalidad alta dependiendo del segmento anatómico involucrado y del tiempo con que se intervenga quirúrgicamente el paciente. En el presente trabajo se reportan los hallazgos clínicos e histopatológicos, el tratamiento quirúrgico, la evolución clínica y el manejo medico post-quirúrgico de dos casos de obstrucciones estrangulantes del colon mayor en equinos referidos a la Clínica Veterinaria Dr. Luis Medina. La historia, sintomatología clínica y pruebas de laboratorio orientaron el diagnóstico, el cual fue confirmado a través de laparotomía exploratoria, la resolución de cada caso fue acompañada con un estudio histológico del segmento intestinal afectado. La resolución en el caso número uno fue por enterotomía de vaciado, mientras que el caso dos fue tratado con reseción del colon mayor con entero anastomosis latero-lateral. Ambos casos sobrevivieron, observándose mejor progreso clínico post-quirúrgico en el caso número dos.
Strangulation obstructions are external vascular constriction with simultaneous blockage of intestinal lumen. It has also been referred cause severe intestinal disease in the horses and commonly related colic. The incidence of this lesion is low with high fatality influenced by anatomic segment involved and rapid surgical intervention at the horse. This paper report the history, clinical signs, histopathologic findings, surgical ma- nagement, clinical progress and post-surgical treatment in two case of strangulation of the large colon in horses sent to the veterinary clinic Dr. Luis Medina. History, physical examination, laboratory test and exploratory laparatomy were used for diagnostic purpose. The resolution of each case has been completed with a histopatlogic study of the anatomic segment involved. The resolution in the case number one was for pelvic flexure enterotomy to decompress the colon torsion. The case number two was threatened with large colon resection and sideto-side anastomosis of left dorsal and ventral colons. Both cases survived however the case two have better clinical progress post-surgical.
Subject(s)
Animals , Abdomen, Acute/veterinary , Horses , Intestine, Large/surgery , Laparotomy/methods , Laparotomy/veterinary , Intestinal Obstruction/surgery , Intestinal Obstruction/veterinary , Veterinary MedicineABSTRACT
Em uma égua, submetida à laparotomia para correção de vólvulo do cólon maior, realizou-se enterectomia próximo ao ligamento cecocólico seguida de enteroanastomose término-terminal. Nas primeiras 24 horas do período pós-operatório, houve piora dos sinais clínicos, com ocorrência de dor, refluxo enterogástrico e agravamento do quadro de endotoxemia. Frente ao prognóstico desfavorável, optou-se pela eutanásia. Durante a necropsia, não foram constatadas falhas na enteroanastomose ou sinais de peritonite séptica. Observou-se encarceramento de uma alça de jejuno, que se apresentava justaposta à extremidade livre da prega cecocólica e comprimida entre o corpo do ceco e o cólon ventral direito remanescente, caracterizando obstrução do tipo estrangulada. Esse achado foi compatível com o agravamento do quadro clínico observado no pós-operatório. Essa ocorrência sugere a necessidade de uma adaptação na técnica de ressecção do cólon maior, de forma a reduzir o espaço cecocólico e evitar um possível encarceramento de alças de intestino delgado.
A mare subjected to laparotomy to treat a large colon volvulus had the large colon transected close to the cecocolic ligament followed by anastomosis using end-to-end technique. Despite intensive care, worsening of the clinical signs occurred during the first 24 hours after surgery including pain, enterogastric reflux and grievance of the endotoxemia symptoms. Euthanasia was performed. During necropsy, no signs of failure of the anastomosis and peritonitis were found but a strangulated segment of jejunum was observed adjacent to the cecocolic fold and compressed by the body of the cecum and the reminiscent rigth ventral colon. This finding was associated with the worsening of the clinical signs during the post-operative period. This report indicates that an adaptation in the large colon resection technique reducing the cecocolic space may be beneficial in avoiding such complication.