Summary
A 2‐month‐old Warmblood colt presented with recurrent colic and regurgitation. Gastroscopy, performed on several occasions, and barium‐contrast radiography revealed severe squamous gastric ulceration and stenosis at the level of the margo plicatus. Treatment with omeprazole reduced the extent and severity of the gastric ulcers but did not affect the stenosis. The foal was euthanised because of a poor prognosis, and post‐mortem examination confirmed the clinical diagnosis. Severe squamous gastric ulceration, granulation tissue formation and cicatrisation of deep gastric lesions were considered to have caused the stenosis. Gastroduodenal outflow obstruction is a recognised disorder in foals, but stenosis at the level of the margo plicatus has not been reported in foals or adult horses. To the authors' knowledge, this is the first case of severe squamous gastric ulceration, complicated by stenosis at the level of the margo plicatus, in a foal. Although rare, gastric stenosis should be considered in foals suffering recurrent colic and regurgitation.
Background
Meckel’s diverticula are a rare cause of small intestinal strangulation, diagnosed at laparotomy or necropsy. This congenital anomaly of the gastrointestinal tract originates from a remnant of the vitelline duct. In reported equine cases, they present as a full-thickness diverticulum on the antimesenteric border of the distal jejunum or proximal ileum.
Case presentation
On laparotomy a Meckel’s diverticulum positioned at the mesenteric side was found to be the cause of small intestinal strangulation. This position is very uncommon and to the best knowledge of the authors there is no unambiguous description of another case.
Conclusions
Meckel’s diverticula should be on the list of differential diagnoses in cases of small intestinal strangulation. As in humans, equine Meckel’s diverticula can have the standard antimesenteric as well as a more exceptional mesenteric location. This case adds to the series of anecdotal reports of anomalies with regard to Meckel’s diverticula in the horse.
A 4-year-old Welsh pony mare presented with anorexia and colic of several days' duration. The mare showed gastric reflux for several days with clinicopathological evidence of inflammation and markedly increased hepatic parameters. Treatment consisted of supportive care and broad-spectrum antimicrobials. Ultrasound revealed hepatopathy and liver biopsy was consistent with bacterial hepatitis. Two weeks later, multiple abscesses could be imaged and the largest abscess was drained percutaneously, under ultrasound guidance. Bacterial culture of the aspirated purulent material yielded Escherichia coli and antimicrobial therapy was switched to oral enrofloxacin for another 2 weeks. The pony made a full clinical recovery and ultrasound revealed improvement in hepatic structure. Two years after discharge from the hospital the pony was reported to be healthy and performing at the expected level.
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