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Epiploic Foramen Entrapment - Horse (view source)
Revision as of 09:25, 4 September 2010
, 09:25, 4 September 2010no edit summary
==Signalment==
==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 age-related 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.
Horses of breeds may be affected but an increased prevalence has been reported in Thoroughbreds. Older horses are thought to be more prone to developing epiploic foramen entrapment and it has been hypothesised that this may be due enlargement of the epiploic foramen following age-related 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==
==Clinical signs==
==Diagnosis==
==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.
Definitive diagnosis of epiploic foramen entrapment may not be straightforward and is often made at surgery. Rectal palpation is often unrewarding due to the anterior position of the lesion but may reveal distended coils of small intestine. 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.
==Treatment==
==Treatment==
If epiploic foramen entrapment is suspected, surgical intervention is required. 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.
==Prognosis==
==Prognosis==
The prognosis following surgical treatment is fair with current reported short-term survival rates of 75% and a 40-70% long term survival rate. The prognosis may be altered by the extent of strangulation observed at surgery and the presence of endotoxaemia.
==References==
==References==
*Bentz, B. (2004) '''Understanding Equine Colic''' ''Eclipse Press''
*Bentz, B. (2004) '''Understanding Equine Colic''' ''Eclipse Press''
*Bertone, J. (2006) '''Equine Geriatric Medicine''' ''Elsevier Health Sciences''
*Mair, T. S. (2003) '''Incarceration and impaction of a short segment of ileum into the epiploic foramen in a horse''' ''Equine Veterinary Education 15 (4) 189-191''
*Mair, T. S. (2003) '''Incarceration and impaction of a short segment of ileum into the epiploic foramen in a horse''' ''Equine Veterinary Education 15 (4) 189-191''
*Orsini, J. A., Divers, T. (2007) '''Equine Emergencies: Treatment and Procedures''' ''Elsevier Health Sciences''
*Orsini, J. A., Divers, T. (2007) '''Equine Emergencies: Treatment and Procedures''' ''Elsevier Health Sciences''
'''[[Colic, Medical Treatment|Medical Treatment of Colic in Horses]]'''</big>
'''[[Colic, Medical Treatment|Medical Treatment of Colic in Horses]]'''</big>
[[Category:Surgical Colic in the Horse]]
[[Category:Surgical Colic in the Horse]]
[[Category:To_Do_-_SophieIgnarski]]
[[Category:To_Do_-_SophieIgnarski]]