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

Abstract

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.