Diagnostic Approach to Colic

Desrochers, Anne; White, Nathaniel A.

doi:10.1002/9781119063254.ch20

Cited by 10 publications

(12 citation statements)

References 78 publications

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“…Furthermore, changes in plasma and peritoneal fluid correlated well with histological scores in a study of intestinal injury in rabbits . When ischemic SI is present, peritoneal fluid lactate typically increases prior to blood lactate . With the onset of concurrent systemic shock, blood lactate values rise steeply to approach peritoneal fluid lactate levels .…”

Section: Discussionmentioning

confidence: 65%

“…35 When ischemic SI is present, peritoneal fluid lactate typically increases prior to blood lactate. 36 With the onset of concurrent systemic shock, blood lactate values rise steeply to approach peritoneal fluid lactate levels. 37 Peritoneal fluid lactate has previously been proposed as superior to blood lactate for predicting the requirement for surgery, intestinal resection, and the probability of survival in colic patients, whereas blood lactate measurement would be more reflective of the cardiovascular status of the horse.…”

Section: Discussionmentioning

confidence: 99%

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Preoperative factors associated with resection and anastomosis in horses presenting with strangulating lesions of the small intestine

Pye

Espinosa‐Mur

Roca³

et al. 2019

Veterinary Surgery

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Objective To determine if preoperative and intraoperative clinical variables correlate with resection and anastomosis (RA) in horses presenting with strangulating small intestinal (SI) lesions. Study design Retrospective case series. Animals Horses undergoing exploratory celiotomy for a strangulating SI lesion (n = 243). Methods The records of horses undergoing surgical correction for strangulating SI lesions from January 1, 2000 to December 31, 2017 were reviewed. Horses were categorized as treated with RA or not treated with RA. Obtained information included history, signalment, clinical findings, diagnostic test results, intraoperative findings, and survival to discharge. Univariable and multivariable analyses were used to compare data between horses treated with RA vs those not treated with RA (P = .05). Results In total, 172 SI lesions were resected, and 71 were not resected. Horses that had gastric reflux at admission to the hospital (odds ratio [OR] 5.56; 95% CI 1.76, 17.59) and horses with amotile SI according to abdominal ultrasonography (OR 9.69; 95% CI 3.09, 30.37) were more likely to undergo RA. Increased difference between peritoneal fluid and blood lactate was higher in horses that underwent RA (OR 1.55; 95% CI 1.12, 2.13). Survival to hospital discharge was lower in the group of horses that underwent RA compared with horses that did not undergo RA. Conclusion Resection and anastomosis of strangulating SI lesions was associated with several preoperative variables. Clinical significance This study highlights the value of preoperative diagnostic procedures in aiding intraoperative decision making and prognostication in horses presenting with strangulating SI lesions.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Preoperative factors associated with resection and anastomosis in horses presenting with strangulating lesions of the small intestine

Pye

Espinosa‐Mur

Roca³

et al. 2019

Veterinary Surgery

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“…The presence of serosanguineous peritoneal fluid in horses with abdominal discomfort and mucous membrane discoloration is strongly associated with intestinal infarction and is a poor prognostic indicator (White 1990; Edwards 1991; Desrochers and White 2017). However, previous authors have strongly advised that the presence of serosanguineous peritoneal fluid should not be used as a sole predictor for surgery (Desrochers and White 2017). Unrelenting pain refractory to analgesia, such as in this case, is also considered a strong indicator for surgical exploration in horses with abdominal discomfort (Edwards 1991).…”

Section: Discussionmentioning

confidence: 99%

“…Transrectal palpation has long been a useful diagnostic aid in the routine assessment of horses with abdominal discomfort, especially in cases of inguinoscrotal herniation. Loops of small intestine or mesentery associated with the internal inguinal ring can often be identified on transrectal palpation by a skilled clinician (Desrochers and White 2017). However, in this case, it was not possible to differentiate the infarcted spermatic cord from an incarcerated segment of bowel in the internal inguinal ring during transrectal palpation.…”

Section: Discussionmentioning

confidence: 99%

Haemoperitoneum secondary to testicular rupture caused by blunt trauma in a stallion

Bonacin

Sousa

Canola

et al. 2019

Equine Veterinary Education

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Summary Testicular trauma is a commonly reported consequence of injury to the scrotum in humans and horses. In the majority of cases in stallions, injury is caused by a kick from a mare during mating. This case report describes a traumatically induced unilateral testicular rupture in a stallion associated with haemoperitoneum and acute, severe signs of abdominal discomfort. Initially, testicular ultrasound and clinical examinations were inconclusive and the clinical signs led to a diagnosis of an inflammatory abdominal disorder, possibly caused by inguinoscrotal herniation. The patient underwent exploratory celiotomy with unilateral orchiectomy at which time no involvement of the gastrointestinal tract was noted (aside from the presence of haemoperitoneum) and the testicular trauma was discovered. As this case demonstrates, testicular trauma should be considered as a differential diagnosis for inguinoscrotal herniation in stallions with clinical signs of discomfort even when there is no history of recent mating. Detailed clinical examination should be performed to establish a diagnosis but may not be conclusive.

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“…Palpation of the distended loop per rectum was not possible due to its abdominal location; however, the thickened caudal flexura of the duodenum indicated an abnormality. The duodenum is located dorsal to the base of the caecum but is rarely palpable, unless it is distended during a peristaltic wave or secondary to small intestinal obstruction (Desrochers and White 2017). The findings confused the preoperative diagnosis and misled us to assume that peritonitis due to uterine rupture might be present (Diekstall et al 2018).…”

confidence: 99%

Strangulation of the duodenum just oral to its caudal flexura caused by a volvulus

Rijkenhuizen¹,

Lichtenberg²

2019

Equine Veterinary Education

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An 8-year-old Haflinger mare with a 10-day-old foal at foot was referred with mild abdominal pain. On the basis of clinical examination, blood and peritoneal fluid analysis, the cause of pain was suspected septic peritonitis. The horse was initially managed medically, with the horse placed in box confinement under close monitoring. No permission was given for an exploratory laparotomy, and it was decided to perform a diagnostic laparoscopy in the standing horse. The laparoscopy revealed a 360-degree anticlockwise partial duodenal volvulus of the caudal descending duodenum, which was manually reduced (hand-assisted laparoscopy). After the release, the mesentery of the duodenum showed an ischaemic band (yellowish white and dark red with a hyperaemic side) and the duodenum had a distinct ischaemic ring (orally and aborally) distinguishing the incarcerated part from the normal duodenum. Ten minutes after the release, the colour remained the same. In conjunction with the owner, it was decided to euthanise the pony. Pathology confirmed the presence of a strangulation ring and the ischaemic condition of the involved duodenum.

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Diagnostic Approach to Colic

Cited by 10 publications

References 78 publications

Preoperative factors associated with resection and anastomosis in horses presenting with strangulating lesions of the small intestine

Preoperative factors associated with resection and anastomosis in horses presenting with strangulating lesions of the small intestine

Haemoperitoneum secondary to testicular rupture caused by blunt trauma in a stallion

Strangulation of the duodenum just oral to its caudal flexura caused by a volvulus

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