Changes

==Pathogenesis==

==Pathogenesis==

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. The length of bowel affected may vary from as little as 10cm to 17m. Strangulation of the affected portion occurs as a result of entrapment in the majority of cases, but minimal vascular impairment may result in the remainder of cases.

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. The length of bowel affected may vary from a few centimetres to 17m. Strangulation of the affected portion occurs as a result of entrapment in the majority of cases, but minimal vascular impairment may result in the remainder of cases.

==Signalment==

==Signalment==

Definitive diagnosis of epiploic foramen entrapment may not be straightforward and is often made at surgery. Rectal palpation is often unrewarding due to the anterior position of the lesion but a marked pain response to traction of the caudal caecal band distended coils of small intestine are features that may distinguish epiploic entrapment from other conditions.  

Definitive diagnosis of epiploic foramen entrapment may not be straightforward and is often made at surgery. Rectal palpation is often unrewarding due to the anterior position of the lesion but a marked pain response to traction of the caudal caecal band distended coils of small intestine are features that may distinguish epiploic entrapment from other conditions.  

Nasogastric reflux is frequently present but may not lead to pain relief.  Transabdominal ultrasonography may reveal distended, hypomotile small intestine. Small intestine identified in the right dorsal quadrant of the abdomen is highly suggestive of the disease. Abdominocentesis is often useful to determine the degree of strangulation and peritoneal fluid may be serosanguineous with an increased lactate, total protein and leukocyte count. See also <big>'''[[:Category:Colic Diagnosis in the Horse|Colic Diagnosis in Horses]]

Nasogastric reflux is frequently present but may not lead to pain relief.  Transabdominal ultrasonography may reveal distended, hypomotile small intestine. Small intestine identified in the right dorsal quadrant of the abdomen is highly suggestive of the disease. Abdominocentesis is often useful to determine the degree of strangulation and peritoneal fluid may be serosanguineous with an increased lactate, total protein and leukocyte count. If the herniation occurs from right to left however, the tranudation enters the omental bursa and may not be collected by abdominocentesis. See also <big>'''[[:Category:Colic Diagnosis in the Horse|Colic Diagnosis in Horses]]

==Treatment==

==Treatment==

    

    

==Prognosis==

==Prognosis==

The prognosis following surgical treatment is fair with current reported short-term survival rates of 75% and  a 40-70% long term survival rate. The prognosis may be altered by the extent of strangulation observed at surgery and the presence of endotoxaemia. Recurrence of epiploic foramen entrapment several months or years later has been reported in a small number of cases.

The prognosis following surgical treatment is considered to be poor, especially of the length of bowel affected is long. The prognosis may be altered by the extent of strangulation observed at surgery and the presence of endotoxaemia. Recurrence of epiploic foramen entrapment several months or years later has been reported in a small number of cases.

==References==

==References==