Surgical Removal of a Descending (Small) Colon Foreign Body through a Secondary Paramedian Approach

Surgical lesions of the small colon and post operative survival in aUKhospital population

“…The majority of these horses were subjected to euthanasia due to an inability to fully exteriorise affected bowel in order to perform a resection and anastomosis. Use of a parainguinal approach allowing increased access to portions of the small colon that may not be exteriorisable via conventional midline laparotomy has been previously described and may allow for resection in a greater percentage of cases. Interestingly, despite the reported difficulties of sufficient small colon exteriorisation, there was no significant difference in the likelihood that a lesion would be inoperable when compared with the small intestine in the present study.…”

Parainguinal laparotomy as an alternative surgical approach for removal of an enterolith in the small colon of a horse

“…Surgical reports for removal of objects from the inaccessible portions of the proximal and distal small colon are few. A left paramedian approach for removal of a proximal small colon faecalith has been reported (de Oliveira Dearo et al . 2009).…”

Secondary approaches to the abdominal cavity for horses with signs of colic may be key to successful resolution of an either very proximal or very distal small colon obstruction

“…A previous case report by de Oliveira Dearo et al . () described a small colon foreign body removal via a second abdominal incision (paramedian approach). During the initial ventral midline exploratory a small colon foreign body was identified but could not be exteriorised via the initial ventral midline abdominal incision for removal via a small colon enterotomy.…”

“…In the report by de Oliveira Dearo et al . () a left paramedian skin incision was made 25 cm lateral to the ventral midline incision. The paramedian incision gave adequate access to the obstruction in the proximal small colon and allowed for removal via a small colon enterotomy.…”

“…This is in contrast to the report by de Oliveira Dearo et al . () who had concerns about a ventral midline incision and a paramedian incision leading to increased wound complications and possible hernia formation. The reports by Anderson et al .…”