Equine Internal Medicine Q&A 23

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

You are asked to examine a seven-year-old Warmblood gelding who has been showing signs of mild abdominal pain for two hours. Physical examination is unremarkable; his mucous membrane colour is pink, he has a heart rate of 36bpm and gut sounds are present, although quieter than might normally be expected. Gastric reflux yields approximately two litres of fluid. Findings on rectal examination are represented diagrammatically.

Question	Answer		Article
Does this description allow you to make a diagnosis?	Physical examination of this horse revealed no signs of cardiovascular compromise. The most significant findings are from rectal examination which reveal displacement of the left colon dorsally, with taut taenial bands converging towards the nephrosplenic space in the left dorsal quadrant of the abdomen. Gas distension of the colon is also present. This combination of findings is characteristic of nephrosplenic entrapment (NSE) or left dorsal displacement of the large colon. In some cases, gas distension may be so severe that it is not possible to palpate beyond the caudal abdomen. Caudomedial displacement of the spleen and impacted food material in the obstructed colon are other findings sometimes recognized with NSE. The amount of fluid retrieved by nasogastric intubation is of questionable significance; it is, however, quite compatible with NSE. Gastric distension can be caused by pressure from distension of an obstructed left ventral colon on the duodenum which is anatomically closely related to the nephrosplenic space in the left dorsal quadrant of the abdomen.		Link to Article