Equine Internal Medicine Q&A 01

This question was provided by Manson Publishing as part of the OVAL Project. See more Equine Internal Medicine questions

This stomach lesion in the image was found in a four-year-old horse which was killed because of an orthopaedic problem. It shows a classic rupture of the stomach wall along the greater curvature. The haemorrhage along the rupture line can help to distinguish this ante-mortem rupture from the equally common post-mortem rupture. This seromuscular rupture had occurred without an associated rupture of the mucosa.

Question	Answer		Article
How can gastric rupture occur?	Gastric rupture can occur as a result of overeating, especially readily fermentable foodstuffs such as grain, grass and foodpulp. More commonly gastric rupture is associated with some form of intestinal obstruction that causes small-intestine contents to reflux into the stomach, where they accumulate and cause distension. The horse has a powerful lower oesophageal sphincter that prevents vomiting. The distension of the stomach may therefore become progressive, resulting in a rising intragastric pressure that ultimately may lead to rupture. Examples of obstructions that can result in gastric rupture include mechanical obstructions of small intestine, paralytic ileus of the intestines (eg. secondary to peritonitis or enteritis, or post-operative ileus), grass sickness (in the UK), intra-abdominal abscesses and adhesions.		Link to Article
What are the clinical signs associated with a complete rupture of the stomach wall?	Signs of gastric rupture are usually preceded by severe pain, increased heart rate, distended abdomen and sometimes retching. Cyanosis may be present. Once the stomach ruptures, the signs of pain may disappear, but the horse develops signs related to acidosis, toxaemia and peracute peritonitis, causing severe depression, sweating and anxiety. Death follows within a few hours.		Link to Article