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− | Herniation/Entrapment
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| {{unfinished}} | | {{unfinished}} |
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| ==Pathogenesis== | | ==Pathogenesis== |
− | The borders of the epiploic foramen are made up of the vena cava, hepatic portal vein, liver and pancreas. Most | + | The epiploic foramen is located in the right dorsal abdomen and is bordered by the vena cava, hepatic portal vein, liver and pancreas. Most incarcerations are caused by small intestine passing from the left side of the abdomen through the epiploic foramen to the right side of the abdomen. The ileum and the jejunum are the most commonly incarcerated portions of small intestine. |
− | incarcerations are caused by small intestine passing from the left side of the abdomen through the epiploic foramen to the | |
− | right side of the abdomen. The ileum and the jejunum are the most commonly incarcerated portions of small intestine. | |
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| ==Signalment== | | ==Signalment== |
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| ==Treatment== | | ==Treatment== |
− | If epiploic foramen entrapment is suspected, surgical intervention is required. A ventral midline exploratory coeliotomy is performed and the the encarcerated portion of intestine is reduced by gentle traction. Decompression may be required prior to reduction if the segment is oedematous or filled with ingesta. Manual dilation of the foramen in order to aid reduction has been suggested by previous authors but this may lead to rupture of the portal vein and great care must be taken when doing so. | + | Initial treatment including gastric decompression, fluid therapy and analgesia. If epiploic foramen entrapment is suspected, surgical intervention is required. Surgical treatment of the condition is not straightforward due to the inaccessibility of the foramen and the delicate surrounding structures. |
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| + | A ventral midline exploratory coeliotomy is performed and the the encarcerated portion of intestine is reduced by gentle traction. Decompression may be required prior to reduction if the segment is oedematous or filled with ingesta. Manual dilation of the foramen in order to aid reduction has been suggested by previous authors but this may lead to rupture of the portal vein and great care must be taken when doing so. The viability of the affected intestine is assessed and a resection and anastamosis may be performed if necessary. |
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| ==Prognosis== | | ==Prognosis== |