Difference between revisions of "Large Colon Torsion - Horse"

Latest revision as of 20:02, 11 July 2012

Also known as: Large Colon Volvulus

Introduction

Large Colon Torsion results from the rotation of the organ about its axis. The degree of torsion dictates the severity of clinical signs and the speed at which the condition progresses. Volvulus can occur at any point along the colon; the most common site is the junction between the caecum and the right ventral colon, and most twist in a clockwise direction, when looking at the horse from behind.

The condition can be described as strangulating if the rotation is greater than 360°, causing vascular as well as luminal obstruction to the intestine. This form of torsion is more serious and acute in presentation, resulting in endotoxaemia and death within hours if treatment is not prompt.

Signalment

Post parturient mares, large breed horses and those with a history of dietary change or grazing on lush pasture are predisposed to the condition.

Clinical Signs

Signs of Colic
Tachycardia
Poor peripheral pulse quality
Tachypnoea
Abdominal distension

On rectal examination the colon is distended and tympanic, the mesentry is palpably oedematous and the colonic bands may be felt in a transverse orientation. See Colic Diagnosis in Horses

Diagnosis

Laboratory Tests

Haemotology and Biochemistry reveal haemoconcentration, changes in acid-base status and electrolyte abnormalities.

Ultrasound

Abdominal ultrasound reveals a distended large colon with thickened, oedematous walls. Peritoneal fluid should be sampled under ultrasound guidance, typical changes include an increase in protein and cellular content.

Treatment

Mild non-strangulating torsions can be managed conservatively but for more severe torsions and all strangulating torsions surgery is vital. Rapid referral for surgical correction is imperative to maximise the chances of a good outcome.

In conjunction with surgical treatment, IV fluids will be needed to replace plasma volume and correct electrolyte abnormalities. Antibiotic drugs, Polymixin B and NSAIDs with anti-endotoxic effects are indicated to minimise the damage from ischaemic intestine. See Medical Treatment of Colic in Horses.

Prognosis

Prognosis depends on the degree of volvulous and the speed of diagnosis and treatment. Torsions of less than 270° have a good prognosis, for more severe torsions, those that are strangulating, or in cases where surgery has been delayed, the prognosis is poor.

Large Colon Torsion - Horse Learning Resources
Literature Search Search for recent publications via CAB Abstract (CABI log in required)	Large Colon Torsion in horses publications

References

Mair, T.S, Divers, T.J, Ducharme, N.G (2002) Manual of Equine Gastroenterology, WB Saunders.
Mair, T., Love, S., Schumacher, J. and Watson, E. (1998) Equine Medicine, Surgery and Reproduction WB Saunders Company Ltd
Merck & Co (2008) The Merck Veterinary Manual (Eighth Edition) Merial
Robinson, N.E., Sprayberry, K.A. (2009) Current Therapy in Equine Medicine (Sixth Edition) Saunders Elsevier
White, N.A., Edwards, G.B. (1999) Handbook of Equine Colic Reed Educational and Professional Publishing Ltd

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@@ Line 1: / Line 1: @@
-Large Colon Torsion is also known as Large colon Volvulus
+{{OpenPagesTop}}
+Also known as: '''''Large Colon Volvulus
-==Description==
+==Introduction==
-Large Colon Torsion results from the rotation of the organ about its long axis. The degree of torsion dictates the severity of clinical signs and the speed at which the condition progresses. Volvulus can occur at any point along the colon; the most common site is the junction between the caecum and the right ventral colon, and most twist in a clockwise direction, when looking at the horse from behind.
+'''Large Colon Torsion''' results from the rotation of the organ about its axis. The degree of torsion dictates the severity of clinical signs and the speed at which the condition progresses. Volvulus can occur at any point along the colon; the most common site is the junction between the caecum and the right ventral colon, and most twist in a clockwise direction, when looking at the horse from behind.
+The condition can be described as '''strangulating''' if the rotation is greater than 360°, causing vascular as well as luminal obstruction to the intestine. This form of torsion is more serious and acute in presentation, resulting in endotoxaemia and death within hours if treatment is not prompt.
-The condition can be described as '''strangulating''' if the rotation is greater than 360°, causing vascular as well as luminal obstruction to the intestine. This form of torsion is more serious and acute in presentation, resulting in endotaemia and death within hours if treatment is not prompt.
 ==Signalment==
 Post parturient mares, large breed horses and those with a history of dietary change or grazing on lush pasture are predisposed to the condition.
-==Diagnosis==
+==Clinical Signs==
-===Clinical Signs===
 * [[Colic Diagnosis - Clinical Signs|Signs of Colic]]
 * Tachycardia
-* Poor periferal pulse quality
+* Poor peripheral pulse quality
-* tachypnoea
+* Tachypnoea
 * Abdominal distension
-On rectal examination the colon is distented and tympanic, the mesentry is palpably oedematous and the colonic bands may be felt in a transverse orientation.
+On [[Rectal Examination of the Horse|rectal examination]] the colon is distended and tympanic, the mesentry is palpably oedematous and the colonic bands may be felt in a transverse orientation.
 See '''[[:Category:Colic Diagnosis in the Horse|Colic Diagnosis in Horses]]'''
+==Diagnosis==
+===Laboratory Tests===
+Haemotology and Biochemistry reveal haemoconcentration, changes in acid-base status and electrolyte abnormalities.
 ===Ultrasound===
-Abdominal ultrasound reveals a distended large colon with oedematous walls. Peritoneal fluid should be sampled under ultrasound guidance, typical changes include an increase in protein and cellular content.
+Abdominal ultrasound reveals a distended large colon with thickened, oedematous walls. [[Colic - Peritoneal Fluid Analysis|Peritoneal fluid should be sampled]] under ultrasound guidance, typical changes include an increase in protein and cellular content.
 ==Treatment==
-Strangulating torsion is a surgical emergency- the horse should go to surgery within 2-4 hours of the onset of clinical signs if the outcome is to be good.
+Mild non-strangulating torsions can be managed conservatively but for more severe torsions and all strangulating torsions surgery is vital. Rapid referral for surgical correction is imperative to maximise the chances of a good outcome.
-See '''[[Colic, Medical Treatment|Medical Treatment of Colic in Horses]]'''
+In conjunction with surgical treatment, IV fluids will be needed to replace plasma volume and correct electrolyte abnormalities. Antibiotic drugs, Polymixin B and NSAIDs with anti-endotoxic effects are indicated to minimise the damage from ischaemic intestine.  See '''[[Colic, Medical Treatment|Medical Treatment of Colic in Horses]]'''.
 ==Prognosis==
-Prognosis depends on the degree of volvulous and the speed of diagnosis and treatment. Torsions of less than 270° have a good prognosis, for more severe torsions, those that are stragulating, or in cases where surgery has been delayed, the prognosis is poor.
+Prognosis depends on the degree of volvulous and the speed of diagnosis and treatment. Torsions of less than 270° have a good prognosis, for more severe torsions, those that are strangulating, or in cases where surgery has been delayed, the prognosis is poor.
+{{Learning
+|literature search = [http://www.cabdirect.org/search.html?q=title%3A%28%22large+colon%22%29+AND+%28title%3A%28volvulus%29+OR+title%3A%28torsion%29%29+AND+od%3A%28horses%29 Large Colon Torsion in horses publications]
+}}
 ==References==
@@ Line 36: / Line 43: @@
 * Mair, T., Love, S., Schumacher, J. and Watson, E. (1998) '''Equine Medicine, Surgery and Reproduction''' ''WB Saunders Company Ltd''
 * Merck & Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''
+* Robinson, N.E., Sprayberry, K.A. (2009) '''Current Therapy in Equine Medicine''' (Sixth Edition) ''Saunders Elsevier''
+* White, N.A., Edwards, G.B. (1999) '''Handbook of Equine Colic''' ''Reed Educational and Professional Publishing Ltd''
+{{review}}
+{{OpenPages}}
 [[Category:Surgical Colic in the Horse]]
-[[Category:To_Do_-_lizzyk]]
+[[Category:Expert_Review]]
+[[Category:Colic - Large Colon Causes]]