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==Description==

'''Left dorsal displacement''', or nephrosplenic entrapment, is a frequent cause of colic, where the left dorsal and ventral colon become displaced, and then trapped by the [[spleen]] laterally, the kidney medially, and the nephrosplenic ligament ventrally. Entrapment over the nephrosplenic ligament results in simple obstruction of the colon, usually without vascular compromise. The exact cause is unknown but it is thought that changes in the ingesta, gas content and motor activity of the colon are important factors.

 

==Introduction==

'''Left dorsal displacement''', or nephrosplenic entrapment, is a frequent cause of colic, where the left dorsal and ventral colon become displaced, and then trapped by the spleen laterally, the kidney medially, and the nephrosplenic ligament ventrally. Entrapment over the nephrosplenic ligament results in simple obstruction of the colon, usually without vascular compromise. The exact cause is unknown but it is thought that changes in the ingesta, gas content and motor activity of the colon are important factors.

==Signalment==

==Signalment==

See '''[[:Category:Colic Diagnosis in the Horse|Colic Diagnosis in Horses]]'''<br>

See '''[[:Category:Colic Diagnosis in the Horse|Colic Diagnosis in Horses]]'''<br>

Rectal examination is usually sufficient to make a diagnosis but in some cases abdominal ultrasound is needed for confirmation. On rectal examination the pelvic flexure or left colon can be felt in the nephrosplenic space, the spleen is often displaced towards the midline. The displaced colon becomes distended with gas due to compression over the nephrosplenic ligament.   

[[Rectal Examination of the Horse|Rectal examination]] is usually sufficient to make a diagnosis but in some cases abdominal ultrasound is needed for confirmation. On rectal examination the pelvic flexure or left colon can be felt in the nephrosplenic space, the spleen is often displaced towards the midline. The displaced colon becomes distended with gas due to compression over the nephrosplenic ligament.   

   

   

===Ultrasound===

===Ultrasound===

Abdominal ultrasound is a sensitive diagnostic tool; the left colon can be identified in the nephrosplenic space, it may partially or completely obscure the left kidney.  

[[Colic Diagnosis - Abdominal Ultrasound|Abdominal ultrasound]] is a sensitive diagnostic tool; the left colon can be identified in the nephrosplenic space, it may partially or completely obscure the left kidney.  

==Treatment==

==Treatment==

The condition can usually be resolved with [[Colic, Medical Treatment|medical management]], IV fluids and analgesia in the form of NSAIDs should be given to correct hydration status and make the horse comfortable.

The condition can usually be resolved with [[Colic, Medical Treatment|medical management]], IV fluids and analgesia in the form of NSAIDs should be given to correct hydration status and make the horse comfortable.

   

   

Mild displacements may respond to the withdrawal of feed, allowing the colon to empty and return to a normal position. This can be aided by the intra-venous administration of [[Interventional_Agents#Phenylephrine|phenylephrine]] which causes splenic contraction, significantly reducing its size and allowing the colon to relocate. Light exercise can also be beneficial to encourage movement of the abdominal contents. Circling on the left rein is considered particularly helpful, as it increases the potential space between the spleen and the body wall, allowing more room for the colon to return to its normal location.  

Mild displacements may respond to the withdrawal of feed, allowing the colon to empty and return to a normal position. This can be aided by the intra-venous administration of [[Interventional_Agents#Phenylephrine|phenylephrine]] which causes splenic contraction, significantly reducing its size and allowing the colon to relocate. Light exercise can also be beneficial to encourage movement of the abdominal contents. Circling on the left rein is considered particularly helpful, as it increases the potential space between the spleen and the body wall, allowing more room for the colon to return to its normal location.  

In some cases the horse can be anaesthetised and a rolling technique used to try and correct the displacement. The procedure involves anaesthestising the horse and placing it in on its right side, lifting it with a hoist and returning it onto the left side. Rectal manipulations can aid the relocation of the colon but it is not always successful.  

In some cases a rolling technique may be used to try and correct the displacement. The procedure involves anaesthestising the horse and placing it on its right side, lifting it with a hoist and returning it onto the left side. Rectal manipulations can aid the relocation of the colon but it is not always successful.  

Where conservative management has failed or in severe cases of left dorsal displacements, surgical exploration and correction is indicated.

Where conservative management has failed or in severe cases of left dorsal displacements, surgical exploration and correction is indicated.

==Prognosis==

==Prognosis==

Prognosis is good; in most cases the condition can be resolved without surgery.  

Prognosis is good; in most cases the condition can be resolved without surgery.  

==References==

==References==

[[Category:Surgical Colic in the Horse]]

[[Category:Surgical Colic in the Horse]]

[[Category:To_Do_-_lizzyk]]

[[Category:Expert_Review]]

[[Category:To_Do_-_Review]]

[[Category:Medical_Colic_in_the_Horse]]

[[Category:Medical_Colic_in_the_Horse]]

[[Category:Colic - Large Colon Causes]]

[[Category:Colic - Large Colon Causes]]