− | Early [[Colic Diagnosis - Rectal Examination|rectal examination]] may reveal the impaction low in the right caudal abdominal quadrant. Subsequent distention of the jejunum will be palpable ''per rectum'' but may preclude palpation of the impaction, thus the definitive diagnosis is often made at surgery. Many horses with ileal impaction are delayed in their referral because initially their colic is mild and their condition deceptively stable. [[Colic Diagnosis - Abdominocentesis|Abdominocentesis]] may show an elevated protein concentration if the impaction has persisted for more than about 18 hours.<ref name="Merck">Merck & Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''', ''Merial''.</ref> The most likely differential diagnosis is '''proximal jejunitis''', which can be challenging to rule out. | + | Early [[Colic Diagnosis - Rectal Examination|rectal examination]] may reveal the impaction low in the right caudal abdominal quadrant. Subsequent distention of the jejunum will be palpable ''per rectum'' but may preclude palpation of the impaction, thus the definitive diagnosis is often made at surgery. Many horses with ileal impaction are delayed in their referral because initially their colic is mild and their condition deceptively stable. [[Colic - Peritoneal Fluid Analysis|Abdominocentesis]] may show an elevated protein concentration if the impaction has persisted for more than about 18 hours.<ref name="Merck">Merck & Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''', ''Merial''.</ref> The most likely differential diagnosis is '''proximal jejunitis''', which can be challenging to rule out. |