Epiploic Foramen Entrapment - Horse

Herniation/Entrapment

Description

Epiploic foramen entrapment in the horse refers to a displacement of small intestine through a small hole or foramen that separates the omental bursa from the peritoneal cavity. The borders of the epiploic foramen are made up of the vena cava, hepatic portal vein, liver and pancreas.

Signalment

Horses of all ages and breed may be affected but older horses are thought to be more prone to developing epiploic foramen entrapment. It has been hypothesised that this may be due enlargement of the epiploic foramen following atrophy of the right liver lobe. However, the disease has also been reported in foals. Crib-biting behaviour is also thought to increase the risk of entrapment.

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. A rare feature of the condition is sudden death due to rupture of the portal vein and subsequent haemorrhage.

Diagnosis

Definitive diagnosis of epiploic foramen entrapment may not be straigtforward and is often made at surgery. Rectal palpation is often unrewarding due to the anterior position of the lesion but may reveal small intestinal distension. Nasogastric reflux is frequently present but may not lead to pain relief. Transabdominal ultrasonography may reveal distended, hypomotile small intestine. Abdominocentesis is often useful to determine the degree of strangulation and peritoneal fluid may be serosanguineous with an increased lactate, total protein and leukocyte count.

References

• Bentz, B. (2004) Understanding Equine Colic Eclipse Press
• 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

See Colic Diagnosis in Horses

Medical Treatment of Colic in Horses

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• Inguinal canal
• Umbilical hernia
• Epiploic foramen
• Mesenteric rents/tears
• Diaphragmatic hernia
• Mesodiverticular bands
• Gastrosplenic ligament