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The severity and speed on onset of clinical signs is determined by the level of the obstruction. Proximal obstructions will progress more rapidly than distal ones.
 
The severity and speed on onset of clinical signs is determined by the level of the obstruction. Proximal obstructions will progress more rapidly than distal ones.
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* Nasogastric reflux
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Passage of a stomach tube will produce nasogastric reflux depending on the site of obstruction and its duration; for a proximal obstruction fluid will build up in the stomach after approximately 3-6 hours, and for a distal obstruction, after 12 hours.    
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On [[Rectal Examination of the Horse|rectal examination]] the small intestine is palpable as distended loops; in the early stages of ileal impaction a tubular structure may be felt in the mid abdomen.  
 
On [[Rectal Examination of the Horse|rectal examination]] the small intestine is palpable as distended loops; in the early stages of ileal impaction a tubular structure may be felt in the mid abdomen.  
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