Changes

==Diagnosis==

==Diagnosis==

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. See <big>'''[[:Category:Colic Diagnosis in the Horse|Colic Diagnosis in Horses]]

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. See also <big>'''[[:Category:Colic Diagnosis in the Horse|Colic Diagnosis in Horses]]

==Treatment==

==Treatment==

Initial treatment consists of gastric decompression, fluid therapy and analgesia.'''[[Colic, Medical Treatment|Medical Treatment of Colic in Horses]]'''</big>  If epiploic foramen entrapment is suspected, surgical intervention is required. Surgical treatment of the condition is not straightforward due to the inaccessibility of the foramen and the delicate surrounding structures.  

Initial treatment consists of gastric decompression, fluid therapy and analgesia. See also '''[[Colic, Medical Treatment|Medical Treatment of Colic in Horses]]'''</big>  If epiploic foramen entrapment is suspected, surgical intervention is required. Surgical treatment of the condition is not straightforward due to the inaccessibility of the foramen and the delicate surrounding structures.  

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. The viability of the affected intestine is assessed and a resection and anastamosis may be performed if necessary.  

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. The viability of the affected intestine is assessed and a resection and anastamosis may be performed if necessary.