Response to early repeat celiotomy in horses after a surgical treatment of jejunal strangulation

Bauck, Anje G.; Easley, Jeremiah T.; Cleary, Orlaith B.; Graham, Sarah; Morton, Alison J.; Rötting, Anna K.; Schaeffer, David J.; Smith, Andrew D.; Freeman, David E.

doi:10.1111/vsu.12670

Cited by 18 publications

(26 citation statements)

References 34 publications

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“…Importantly, the above clinical signs may also be present in other conditions, particularly those associated with a mechanical obstruction to the aboral passage of SI ingesta and fluid. In a more recent study of 22 horses that underwent relaparotomy, 16 of 19 horses with precipitating clinical signs (POR and post-operative colic) had these clinical signs eliminated by relaparotomy; furthermore, the authors reported that relaparotomy did not appear to exacerbate the POR [27]. Clinical distinction between a functional and physical obstruction is challenging.…”

Section: Diagnosis Of Equine Poimechanical Versus Functionalmentioning

confidence: 99%

An update on equine post‐operative ileus: Definitions, pathophysiology and management

Lisowski

Pirie

Blikslager

et al. 2018

Equine Veterinary Journal

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Post-operative ileus (POI) is a serious condition which any horse undergoing abdominal surgery is at risk of developing, leading to increased hospitalisation time and resulting costs. Advances in the understanding of the development of equine POI are mainly based on human and rodent literature, where manipulation-induced inflammation has been identified as a trigger, with activation of resident muscularis externa macrophages playing a crucial role in the pathophysiology. Despite many pharmacological trials in all species, there is no single completely successful treatment for POI, highlighting that the condition is multifactorial in cause and requires a multimodal approach to minimise its incidence.

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Section: Diagnosis Of Equine Poimechanical Versus Functionalmentioning

confidence: 99%

An update on equine post‐operative ileus: Definitions, pathophysiology and management

Lisowski

Pirie

Blikslager

et al. 2018

Equine Veterinary Journal

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“…Also, in the author's experience, anastomotic impactions develop within the first 12 h post‐operatively (Bauck et al . ), presumably because the only remaining solid material is moved from the stomach or proximal small intestine to the anastomosis in that timeframe. Early provision of energy is not the goal of an early refeeding programme, although refeeding can prevent hypertriglyceridaemia and eliminate the need for parenteral nutrition (Underwood et al .…”

Section: Post‐operative Feedingmentioning

confidence: 99%

Post‐operative reflux – a surgeon's perspective

Freeman

2017

Equine Veterinary Education

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Summary Post‐operative ileus (POI) is a well‐recognised complication of colic surgery that accounts for a high proportion of post‐operative deaths. Although much has been written about the pathophysiology and management of POI in horses, most studies seem to apply research findings to the clinical case without full regard for the clinical evidence. Although much attention has focused recently on the role of inflammation, this narrow focus might explain our failure to make important advances in managing horses with this complication. This commentary is offered to redirect our current thinking about POI away from an approach that predominantly emphasises a functional disorder and medical management, to one that addresses surgical prevention.

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“…Horses with incisional drainage were 17.8–62.5 times more likely to develop an incisional hernia than horses without incisional drainage 6,31 . Repeat laparotomy performed through the same incision is a risk factor for incisional infections as well as incisional hernias 2,78–80 . The incidence of incisional hernias was 8% in 300 horses that underwent 1 emergency celiotomy; hernia rate increased to 25% following a second surgery performed through the same incision 79 .…”

Section: Introductionmentioning

confidence: 99%

Incisional infections associated with ventral midline celiotomy in horses

Shearer

Holcombe

Valberg

2020

J Vet Emergen Crit Care

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Objective To review the veterinary literature regarding healing and complications associated with equine celiotomy including anatomy and physiology, risk factors for incisional infection and hernia, and treatment. Etiology Celiotomy is the most common approach to treat horses with surgical colic. Incision through the linea alba provides exposure to most of the abdomen for exploration, exteriorization, and correction of surgical lesions. Incisional apposition relies on suture strength during anesthetic recovery and for the first 30 days postoperatively. Factors associated with the patient, surgical lesion and procedures, anesthesia, and recovery put the horse at risk for surgical site infection. Infection is the most important risk factor for incisional hernia formation. Diagnosis A presumptive diagnosis of surgical site infection is made based on the presence of fever and incisional swelling, pain, and discharge. Ultrasonography can be used to identify areas of fluid accumulation prior to the appearance of incisional drainage. Definitive diagnosis is based on positive bacteriologic culture of the incisional discharge. Incisional hernia is diagnosed by palpation of the incision, usually 30–60 days after surgery. Ultrasound of the incision may aide in early diagnosis of incisional hernia if gaps along the incision in the linea alba are apparent. Therapy No objective data exist to assess the efficacy of specific therapies for surgical site infections following celiotomy. Principles of treatment include the establishment of drainage, bandaging, antimicrobial therapy based on culture and sensitivity, and extended rest in an attempt to avoid incisional hernia or dehiscence. Treatment for incisional hernia includes prolonged circumferential bandaging, open or minimally invasive hernia repair, or no treatment. Prognosis Incisional complications are associated with prolonged convalescence and diminished prognosis for return to athleticism. Limiting risk factors for surgical site infections, prompt treatment, and incisional support may optimize celiotomy healing and timely return to function. Horses compete in many disciplines with incisional hernias.

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Response to early repeat celiotomy in horses after a surgical treatment of jejunal strangulation

Abstract: 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.

Cited by 18 publications

References 34 publications

An update on equine post‐operative ileus: Definitions, pathophysiology and management

An update on equine post‐operative ileus: Definitions, pathophysiology and management

Post‐operative reflux – a surgeon's perspective

Incisional infections associated with ventral midline celiotomy in horses

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