Changes

==Clinical signs==

==Clinical signs==

The presentation of this condition is similar to that of other strangulating lesions such as small intestinal volvulus. Horses with epiploic foramen entrapment frequently exhibit acute onset and severe abdominal pain that is usually non-responsive to analgesia. This is often characterised by clinical signs including rolling, pawing at the ground, flank watching and kicking at the abdomen. Other clinical signs may include tachycardia, tachypnoea, reduced borborygmy. Signs of endotoxaemia may be present including prolonged capillary refill time and congested mucous membranes. A rare feature of the condition is sudden death due to rupture of the portal vein and subsequent haemorrhage.

The presentation of this condition is similar to that of other strangulating lesions such as small intestinal volvulus. Horses with epiploic foramen entrapment frequently exhibit acute onset and severe abdominal pain that is usually non-responsive to analgesia. This is often characterised by clinical signs including rolling, pawing at the ground, flank watching and kicking at the abdomen. Other clinical signs may include tachycardia, tachypnoea, reduced borborygmi. Signs of endotoxaemia may be present including prolonged capillary refill time and congested mucous membranes. A rare feature of the condition is sudden death due to rupture of the portal vein and subsequent haemorrhage.

==Diagnosis==

==Diagnosis==

==Treatment==

==Treatment==

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.  

Initial treatment consists of 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.  

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.  

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.