Tears of the manica flexoria are a well-known cause of lameness in horses, and endoscopic resection using a 3-or 4-portal approach has a good success rate. This article describes the feasibility of a two-portal technique to resect the manica flexoria based on cadavers and a prospective clinical study. This technique is less invasive regarding the number of portals, allows more precise instrument handling as all sharp instruments used to transect the manica flexoria are always under visualisation and has reduced ergonomic risks for the surgeon compared with the multiple portal approaches. Fifteen of the 21 (71%) operated horses returned to pre-injury level, comparable to the results obtained with previous techniques.

Three mares underwent diagnostic laparoscopy because of suspicion of post-partum uterine ruptures. All three horses showed clinical signs of a uterine rupture between 1 and 3 days after parturition and underwent diagnostic laparoscopy. In all cases a full thickness uterine rupture could be detected and was sutured laparoscopically. Availability of suture material and surgeon experience were responsible for the surgical methods chosen for repair. In the first case, a hand-assisted laparoscopic approach was chosen for suturing the ruptured uterus, whereas in the other cases the approach was entirely laparoscopic. In the second case, extracorporeal knots were used for the repair and in the last case described a barbed loop suture was available for closure of the uterus. Two of three mares were alive for at least 12 months after surgery without any abdominal problems. One of these mares delivered a healthy foal 2 years after surgery. The remaining mare died 3 months after surgery but no necropsy was done. Laparoscopy should be considered for post-partum mares with signs of peritonitis to access the uterus and repair a rupture if it is accessible. A laparoscopic approach using intracorporeal knots or barbed sutures for the repair of the uterine rupture as well as a handassisted laparoscopic approach are feasible. The use of the barbed suture for intracorporeal closure makes the minimal invasive laparoscopic technique easier to perform.

A 22-year-old, non-pregnant, retired pasture pony was presented with severe and sudden-onset haemorrhage from the vulva. Transrectal palpation revealed a mass in the right uterine horn. Laparoscopic partial ovariohysterectomy was performed and a histopathologic examination of the tumour revealed a uterine leiomyoma. The mare recovered without complications and was discharged nine days later. Both four and eighteen months after discharge, the mare was found to be in a good general condition, enjoying her retirement without any clinical complaints.

A 6-year-old Warmblood gelding was referred for acute colic signs and stranguria. Clinical examination revealed reduced anal and tail tone as well as an intra-abdominal mass palpable per-rectum. The mass prevented the palpation of normal abdominal structures. The horse was subjected to standing diagnostic laparoscopy which revealed a retroperitoneal hematoma extending from the root of the mesentery to the mesorectum, bulging to the left side of the abdomen. The horse was initially managed medically, with the horse placed in box confinement under close monitoring. The colic signs subsided, however, a progressive paralysis of the horse`s tail and the inability to defecate became worse. The horse subsequently underwent a diagnostic laparotomy where the origin of the hematoma could be localized in the mesorectum. The horse was euthanized intraoperatively due to the size and location of the hematoma. The worsening of the neurological signs was theorized to have been caused by compression of the neural structures by the expanding hematoma.

120Hepatic haematoma rupture in a Warmblood: a rare complication of hepatic AA amyloidosis M. Diekstall et al. Summary:A 15-year-old Warmblood gelding was referred to the clinic because of abdominal discomfort. One year before clinical evaluation, the horse presented with a mass in the back muscles that had first appeared 3 years prior. The mass, located in the caudal saddle position, was of an unknown cause and did not disturb the horse in any way. A calcification was recognized radiologically; however, treatment was not pursued because of high risk of poor wound healing and infection in this area. On the day of referral the horse was presenting signs of colic as a result of a haemoperitoneum following a ruptured haematoma in the liver, which was diagnosed by laparoscopy in the standing position. The horse was euthanized because of persistent, extensive haemorrhage from the unstoppable bleeding of the liver. At necropsy liver amyloidosis with subcapsular and intrahepatic haematoma was diagnosed. The calcified mass in the horse's back muscle was considered to be an old infected wound that could be the trigger for Amyloid-A (AA) amyloidosis. To the author's knowledge, this condition has not yet been described in horses. Citation: Diekstall M., Veh J., Rijkenhuizen A. B. M. (2019) Hepatic haematoma rupture in a Warmblood: a rare complication of hepatic AA amyloidosis. Pferdeheilkunde 35, 120-125;