Repeat celiotomy can eliminate signs of POR and/or POC, and the additional surgery does not appear to aggravate POR. Criteria for repeat celiotomy in this study could provide guidelines for managing POC and POR after surgery for jejunal strangulation.

OBJECTIVE To examine effects of continuous rate infusion of lidocaine on transmural neutrophil infiltration in equine intestine subjected to manipulation only and remote to ischemic intestine. ANIMALS 14 healthy horses. PROCEDURES Ventral midline celiotomy was performed (time 0). Mild ischemia was induced in segments of jejunum and large colon. A 1-m segment of jejunum was manipulated by massaging the jejunal wall 10 times. Horses received lidocaine (n = 7) or saline (0.9% NaCl) solution (7) throughout anesthesia. Biopsy specimens were collected and used to assess tissue injury, neutrophil influx, cyclooxygenase expression, and hypoxia-inducible factor 1α (HIF-1α) expression at 0, 1, and 4 hours after manipulation and ischemia. Transepithelial resistance (TER) and mannitol flux were measured by use of Ussing chambers. RESULTS Lidocaine did not consistently decrease neutrophil infiltration in ischemic, manipulated, or control tissues at 4 hours. Lidocaine significantly reduced circular muscle and overall scores for cyclooxygenase-2 expression in manipulated tissues. Manipulated tissues had significantly less HIF-1α expression at 4 hours than did control tissues. Mucosa from manipulated and control segments obtained at 4 hours had lower TER and greater mannitol flux than did control tissues at 0 hours. Lidocaine did not significantly decrease calprotectin expression. Severity of neutrophil infiltration was similar in control, ischemic, and manipulated tissues at 4 hours. CONCLUSIONS AND CLINICAL RELEVANCE Manipulated jejunum did not have a significantly greater increase in neutrophil infiltration, compared with 4-hour control (nonmanipulated) jejunum remote to sites of manipulation, ischemia, and reperfusion. Lidocaine did not consistently reduce neutrophil infiltration in jejunum.

Summary Small intestinal strangulation was found at necropsy in the left mesometrium of a nonpregnant 10‐year‐old Quarter Horse mare subjected to euthanasia because of colic. The tear had smooth fibrotic edges, consistent with its development in one of two normal pregnancies, the last one at least 1 year preceding admission. This is a rare lesion and this report demonstrates that such a tear can develop during pregnancy without inducing small intestinal strangulation and that pregnancy is not required for strangulation to develop later. Therefore, all attempts should be made to close such tears at the time of initial surgery, if accessible, or later as a planned laparoscopic procedure.

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Objective: To describe a modified celiotomy to improve access to cranial abdominal structures in horses. Animals: Four horses. Study design: Short case series. Methods: Three horses with gastric impactions were treated with gastrotomies. One horse was treated for a diaphragmatic hernia with herniorrhaphy and mesh augmentation. In all horses, the ventral midline celiotomy was modified cranially with a J-incision through the body wall, along the paracostal arch. Results: The only surgical complications were midline incisional infections in all horses. Three of the four horses had good long-term outcomes; the remaining horse underwent euthanasia for reasons likely unrelated to incisional complications. Conclusion: The J-incision improved access to the stomach and diaphragm in these horses. The paracostal component healed in all cases without evidence of infection or dehiscence. Clinical significance: This modified celiotomy may be considered to improve access during gastrotomy and repair of dorsally located diaphragmatic hernias.