Haemoabdomen and colitis following a colon displacement in a 9‐year‐old Thoroughbred mare

Abstract

Summary This report describes acute haemoabdomen following phenylephrine administration in a case treated for left dorsal displacement of the large colon. The horse also subsequently developed a severe colitis which was treated with aggressive medical therapy.

Surgical Correction of Nephrosplenic Entrapment of the Large Colon in 3 Horses Via Standing Left Flank Laparotomy

“…Advantages of a standing flank laparotomy are avoiding general anesthesia that precludes the incidence of complications associated with anesthesia and rolling, shortened recovery time, and decreased costs associated with hospitalization and postoperative care. Additionally, a standing left flank laparotomy without the use of phenylephrine may be warranted in high risk horses like older broodmares or aged horses >15 years based on recent reports . The technical skill, colonic gas distension, and presence of secondary lesions may prevent its use in most hospital settings…”

“…Medical therapy commonly includes intravenous (IV) fluid therapy and analgesics; phenylephrine administration with jogging; rolling under general anesthesia; withholding of food; administration of magnesium sulfate and/or over‐hydration with IV and enteral fluids . Complications of medical therapy alone include cecal torsion, phenylephrine‐associated severe hemorrhage, hemoabdomen, and gastrointestinal rupture . Surgical correction under general anesthesia via a ventral median celiotomy is commonly performed and has a low incidence of complications that include incisional infection, pulmonary edema, anesthetic death, adhesions, dehiscence, ventral hernia formation, and anesthesia recovery injury .…”

Complicated colic case raises interesting questions: What can we learn?

“…As a side comment regarding cytological differentiation of the source of blood described by Compostella et al . (2012), the PCV of the peritoneal fluid obtained following abdominocentesis can also be used to differentiate an accidental splenic puncture from a haemoabdomen; the PCV following splenic puncture is typically higher than that of peripheral blood whereas the fluid from horses with a haemoabdomen is usually variably lower than that of peripheral blood.…”

“…Surgery on a horse with a haemoabdomen is generally not recommended without further diagnostic procedures (e.g. complete abdominal ultrasonographic examination) and patient stabilisation or, as in the case report by Compostella et al . (2012), if the horse is uncontrollably painful leaving no other option.…”

“…The case report by Compostella et al . (2012) of haemoabdomen and colitis following a colon displacement in a 9‐year‐old Thoroughbred mare highlights some of the diagnostic and therapeutic challenges we still face with equine colic.…”