Difference between revisions of "Intussusception - Horse"

Revision as of 10:21, 4 August 2010

Medical Treatment of Colic in Horses

Description

An intussusception is an invagination of a length of intestine (the intussusceptum) into an adjacent more distal segment (the intussuscipiens). The small intestine is the most common site for this to occur. Intussuception in the horse most commonly involves the ileum (ileo-caecal or ileo-ileal), with jejuno-jejunal intussusceptions being rarer.

Signalment

Horses less than three years of age are most commonly affected. There is no breed or sex predilection.

Clinical signs

Clinical signs are dependent on whether the obstruction is partial or complete. Complete obstructions are characterised by acute onset, severe abdominal pain. Vascular impairment is a feature of complete obstructions and strangulation usually occurs. Large volumes of gastric reflux may be obtained and loops of distended small intestine may be palpated on rectal examination.

Partial obstructions are associated with more chronic clinical signs. Abdominal pain may be mild and intermittent. Clinical signs may occur over a period of weeks, during which time muscular hypertrophy of the intestine proximal to the partial obstruction occurs.

Diagnosis

Abdominal ultrasonography may reveal a characteristic target or 'bulls eye' lesion. Peristalsis in the affected region is reduced or absent. Oedema and thickening of the intestinal wall are often seen with a distended, fluid filled region proximal to the intussusception.

References

McIlwraith, C. W., Turner, Robertson, J. T. (1998) McIlwraith & Turner's Equine Surgery: advanced techniques Wiley-Blackwell

Orsini, J. A., Divers, T. (2007) Equine Emergencies: Treatment and Procedures Elsevier Health Sciences

Radostits, O. M., Arundel, J. H., Gay, C. C. (2000) Veterinary Medicine: A textbook of the diseases of cattle, sheep, pigs, goats and horses Elsevier Health Sciences

White, N. A., Edwards, B (1999) Handbook of Equine Colic Butterworth Heinemann

This is a condition in which one part of the intestine "telescopes" inside another. Usually this obstructs the blood flow to the inner part, and so forms a strangulating obstruction. Intussusception can occur within the small intestine, and also between small intestine and caecum (ileo-caecal intussusception). The latter is predisposed by Anoplocephala perfoliata tapeworm infection. When working up an acute abdominal case, it must be borne in mind that this form of colic is serious and necessitates surgery, however, peritoneal fluid changes will not usually be seen, as will often be found in a surgical colic. This is because the strangulated portion of gut (the inside of the "telescope"), is contained within an intact piece of intestine, so leaking fluid and protein is contained from the peritoneal cavity.

@@ Line 1: / Line 1: @@
-{{OpenPagesTop}}
+See <big>'''[[:Category:Colic Diagnosis in the Horse|Colic Diagnosis in Horses]]
-==Introduction==
-An intussusception is an invagination or 'telescoping' of a length of intestine (the intussusceptum) into an adjacent, more distal segment (the intussuscipiens). The small intestine is the most common site for this to occur and the affected segment may range in length from a few centimeters up to a metre. Intussuception in the horse most commonly involves the ileum (ileo-caecal or ileo-ileal). Jejuno-jejunal intussusceptions also occur in the horse but they are considerably less common.
-The aetiology of the condition is not fully understood, but is thought to be due to underlying disorders of gut motility. This may be due to one of several conditions including parasitism, enteritis, use of anthelmintics and surgical trauma.
+'''[[Colic, Medical Treatment|Medical Treatment of Colic in Horses]]'''</big>
-==Signalment==
-Small intestinal intussusceptions can occur in horses of all ages but those aged between six months to three years are most commonly affected. There is no breed or sex predilection.
-==Clinical signs==
+{{unfinished}}
-Clinical signs are dependent on whether the obstruction caused by the intussusception is partial or complete. Complete obstructions are characterised by acute onset, severe abdominal pain. Vascular impairment is a feature of complete obstructions and strangulation usually occurs, leading to clinical signs of tachycardia, tachypnoea, prolonged capillary refill time and congested mucous membranes. Borborygmi are often absent or significantly reduced. Large volumes of gastric reflux may be obtained and loops of distended small intestine may be palpated on rectal examination.
-Partial obstructions are associated with more chronic clinical signs. Abdominal pain may be mild and intermittent, often coinciding with feeding. Other clinical signs may include weight loss and reduced faecal output. Signs may occur over a period of weeks, during which time muscular hypertrophy of the intestine proximal to the partial obstruction occurs which is often recognisable at laparotomy.
+===Description===
-==Diagnosis==
+An intussusception is an invagination of a length of intestine (the intussusceptum) into an adjacent more distal segment (the intussuscipiens). The small intestine is the most common site for this to occur. Intussuception in the horse most commonly involves the ileum (ileo-caecal or ileo-ileal), with jejuno-jejunal intussusceptions being rarer.
-Diagnosis of intussusception in the horse may be difficult as [[Colic - Peritoneal Fluid Analysis|abdominocentesis]] rarely reveals any abnormalities. This is due to the strangulated portion of gut being contained within the intussuscipiens. In the case of jejuno-jejunal intussusceptions, rectal examination may reveal a sausage-shaped, tubular structure in the mid abdomen of the horse. The presence of melaena is a significant finding and may raise clinical suspicion of intussusception. [[Colic Diagnosis - Abdominal Ultrasound|Abdominal ultrasonography]] may reveal a characteristic target or 'bulls-eye' lesion on transverse section. Peristalsis in the affected segment is reduced or absent. Oedema and thickening (>3mm) of the intestinal wall are often seen with a distended, fluid-filled region proximal to the intussusception.
-Definitive diagnosis, however, is often based on findings at laparotomy.
+===Signalment===
-See also <big>'''[[:Category:Colic Diagnosis in the Horse|Colic Diagnosis in Horses]]</big>
+Horses less than three years of age are most commonly affected. There is no breed or sex predilection.
+===Clinical signs===
+Clinical signs are dependent on whether the obstruction is partial or complete. Complete obstructions are characterised by acute onset, severe abdominal pain. Vascular impairment is a feature of complete obstructions and strangulation usually occurs. Large volumes of gastric reflux may be obtained and loops of distended small intestine may be palpated on rectal examination.
-==Treatment==
+Partial obstructions are associated with more chronic clinical signs. Abdominal pain may be mild and intermittent. Clinical signs may occur over a period of weeks, during which time muscular hypertrophy of the intestine proximal to the partial obstruction occurs.
-Treatment is surgical reduction of the affected region of intestine followed by resection and anastamosis. Although reduction alone without resection has been reported, this technique is not recommended due to the high possibility of recurrence.
-<big>See also '''[[Colic, Medical Treatment|Medical Treatment of Colic in Horses]]'''</big>
+===Diagnosis===
-==Prognosis==
+Abdominal ultrasonography may reveal a characteristic target or 'bulls eye' lesion.  Peristalsis in the affected region is reduced or absent. Oedema and thickening of the intestinal wall are often seen with a distended, fluid filled region proximal to the intussusception.
-The prognosis is good if surgery is performed before the intussusception has become irreducible. The prognosis is poorer if reduction is not possible due to the increased rate of post-operative complications including ileus, adhesions, peritonitis and endotoxaemia.
-{{Learning
-|literature search = [http://www.cabdirect.org/search.html?q=title%3A%28intussusception%29+AND+od%3A%28horses%29 Intussusception in horses publications]
-}}
-==References==
+===References===
-*Knottenbelt, D. C., Pascoe, R. R. (2003) '''Diseases and Disorders of the Horse''' ''Elsevier Health Sciences''
 *McIlwraith, C. W., Turner, Robertson, J. T. (1998) '''McIlwraith & Turner's Equine Surgery: advanced techniques''' ''Wiley-Blackwell''
 *Orsini, J. A., Divers, T. (2007) '''Equine Emergencies: Treatment and Procedures''' ''Elsevier Health Sciences''
@@ Line 44: / Line 37: @@
-{{review}}
+This is a condition in which one part of the intestine "telescopes" inside another.  Usually this obstructs the blood flow to the inner part, and so forms a strangulating obstruction.  Intussusception can occur within the small intestine, and also between small intestine and caecum (ileo-caecal intussusception).  The latter is predisposed by Anoplocephala perfoliata tapeworm infection.  When working up an acute abdominal case, it must be borne in mind that this form of colic is serious and necessitates surgery, however, peritoneal fluid changes will not usually be seen, as will often be found in a surgical colic.  This is because the strangulated portion of gut (the inside of the "telescope"), is contained within an intact piece of intestine, so leaking fluid and protein is contained from the peritoneal cavity.
-{{OpenPages}}
-[[Category:Colic - Small Intestinal Causes]]
 [[Category:Surgical Colic in the Horse]]
-[[Category:Expert_Review]]
+[[Category:To_Do_-_SophieIgnarski]]
-[[Category:Small Intestinal Diseases - Horse]]