Difference between revisions of "Left Dorsal Displacement of Large Colon - Horse"

Revision as of 20:28, 31 August 2010

Also known as Nephrosplenic Entrapment

Description

Left dorsal displacement is a type of in the horse in which the left colon becomes displaced and lodged in the nephrosplenic space. Entrapment over the nephrosplenic ligament results in simple obstruction of the colon, usually without vascular compromise. The exact cause is unknown but it is thought that changes in the ingesta, gas content and motor activity of the colon are important factors.

Signalment

Large breed and wide bodied horses are predisposed to this condition.

Diagnosis

Clinical Signs

Moderate abdominal pain and signs of colic
Mild tachycardia
Decreased faecal output
Inappetence

See Colic Diagnosis in Horses
Rectal examination is usually sufficient to make a diagnosis but in some cases abdominal ultrasound is needed for confirmation. On rectal examination the pelvic flexure or left colon can be felt in the nephrosplenic space, the spleen is often displaced towards the midline. The displaced colon becomes distended with gas due to compression over the nephrosplenic ligament.

Ultrasound

Abdominal ultrasound is a sensitive diagnostic tool; the left colon can be identified in the nephrosplenic space, it may partially or completely obscure the left kidney.

Treatment

The condition can usually be resolved with medical management, IV fluids and analgesia in the form of NSAIDs should be given to correct hydration status and make the horse comfortatble. Mild displacements may respond to the withdrawal of feed, allowing the colon to empty and return to a normal position. This can be aided by the administration of phenylephrine which causes splenic contraction, significantly reducing its size and allowing the colon to relocate. Light excercise such as trotting on the lunge can also be beneficial.

In some cases the horse can be anaesthetised and a rolling technique used to try and correct the displacement. The proceedure involves anaethestising the horse and placing it in on its right side, lifting it with a hoist and returning it onto the left side. Rectal manipulations can aid the relocation of the colon but it is not always successful.

Where conservative management has failed or in severe cases of left dorsal displacements, surgical exploration and correction is indicated.

Prognosis

Prognosis is good, in most cases the condidtion can be resolved without surgery.

References

Mair, T.S, Divers, T.J, Ducharme, N.G (2002) Manual of Equine Gastroenterology, WB Saunders.
Merck & Co (2008) The Merck Veterinary Manual (Eighth Edition) Merial
Robinson, N.E., Sprayberry, K.A. (2009) Current Therapy in Equine Medicine (Sixth Edition) Saunders Elsevier
Rose, R. J. and Hodgson, D. R. (2000) Manual of Equine Practice (Second Edition) Sauders
White, N.A., Edwards, G.B. (1999) Handbook of Equine Colic Reed Educational and Professional Publishing Ltd

@@ Line 1: / Line 1: @@
 {{Unfinished}}
-Also known as Nephrosplenic entrapment
+Also known as Nephrosplenic Entrapment
 ==Description==
-The left colon becomes displaced and lodged in the nephrosplenic space. Entrapment over the nephrosplenic ligament results in simple obstrcuction of the colon, usually without vascular compromise. The exact cause is unknown but it is thought that changes in the ingesta, gas content and motor activity of the colon are important factors.
+'''Left dorsal displacement''' is a type of [[Category:Colic in Horses|colic]] in the horse in which the left colon becomes displaced and lodged in the nephrosplenic space. Entrapment over the nephrosplenic ligament results in simple obstruction of the colon, usually without vascular compromise. The exact cause is unknown but it is thought that changes in the ingesta, gas content and motor activity of the colon are important factors.
 ==Signalment==
@@ Line 16: / Line 16: @@
 * Inappetence
-See '''[[:Category:Colic Diagnosis in the Horse|Colic Diagnosis in Horses]]'''
+See '''[[:Category:Colic Diagnosis in the Horse|Colic Diagnosis in Horses]]'''<br>
-Diagnosis is usually made on a combination of rectal examination and abdominal ultrasound. On rectal examination the pelvic flexure or left colon can be felt in the nephrosplenic space, the spleen is often displaced towards the midline. The displaced colon becomes distended with gas due to compression over the nephrosplenic ligament.
+Rectal examination is usually sufficient to make a diagnosis but in some cases abdominal ultrasound is needed for confirmation. On rectal examination the pelvic flexure or left colon can be felt in the nephrosplenic space, the spleen is often displaced towards the midline. The displaced colon becomes distended with gas due to compression over the nephrosplenic ligament.
 ===Ultrasound===