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J Am Vet Med Assoc ; 245(7): 816-20, 2014 Oct 01.
Article in English | MEDLINE | ID: mdl-25229534

ABSTRACT

CASE DESCRIPTION: An 8-year-old multiparous Thoroughbred broodmare was admitted for evaluation of a rectal tear sustained during parturition. CLINICAL FINDINGS: On initial evaluation, the mare had mild signs of abdominal discomfort. A full-thickness rectal tear located 30 cm cranial to the anus and extending approximately 15 cm longitudinally along the surface of the small colon between the 4 and 6 o'clock positions, when viewed from behind, was diagnosed on examination per rectum. TREATMENT AND OUTCOME: Laparoscopic evaluation of the abdomen was performed to assess the tear and extent of peritoneal contamination. A hand-assisted repair via a flank incision was performed. The tear was closed in a single-layer, simple continuous pattern with size-0 polydioxanone with a handheld needle holder. Subsequently, a ventral midline celiotomy was performed, and intestinal contents were evacuated via a pelvic flexure enterotomy and a typhlotomy. Following surgery, the mare was managed with IV fluid therapy, partial parenteral nutrition, antimicrobials, and NSAIDs for 5 to 7 days before being gradually reintroduced to a complete pelleted feed and alfalfa hay. Prior to discharge, examination per rectum revealed no stricture formation associated with repair. The mare was discharged from the hospital and performed successfully as a broodmare, with the delivery of a live foal 1 year after surgery. CLINICAL RELEVANCE: Successful repair with an excellent outcome was achieved in this mare. Hand-assisted laparoscopic repair should be considered as a possible treatment option in horses with grade IV rectal tears.


Subject(s)
Hand-Assisted Laparoscopy/veterinary , Horse Diseases/surgery , Obstetric Labor Complications/veterinary , Rectum/injuries , Wounds and Injuries/veterinary , Animals , Female , Horses , Obstetric Labor Complications/surgery , Pregnancy , Wounds and Injuries/surgery
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