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If impaction remains unresolved, pain becomes uncontrollable, or extensive gas distension of the colon occurs, surgery is indicated.  Abodominocentesis can be used to monitor the onset of intestinal compromise.(83)  At surgery the contents of the colon are evacuated via a pelvic flexure enterotomy.
 
If impaction remains unresolved, pain becomes uncontrollable, or extensive gas distension of the colon occurs, surgery is indicated.  Abodominocentesis can be used to monitor the onset of intestinal compromise.(83)  At surgery the contents of the colon are evacuated via a pelvic flexure enterotomy.
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==Prognosis==
 
==Prognosis==
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Good for impactions that resolve medically (95% long term survival in one study) and fair in horses that require surgical intervention (58% long-term survival in the same study) (84)
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==Prevention==
 
==Prevention==
  
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