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  Discussion on Research Summary: small intestinal incarceration through the gastrosplenic ligament
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DrO

Posted on Friday, Oct 19, 2007 - 1:01 pm:

Historically this type of small bowel displacement has a poor prognosis because of the rapidly developing bowel necrosis > peritonitis > toxemia and septicemia. Early diagnosis and surgery improved the prognosis in this study. I think the most important part of this study is the clinical findings that could help lead to the early diagnosis of a surgical disease: small bowel distension on rectal examination and changes in the peritoneal fluid stand out as reliable early indicators and would be seen in most cases of small bowel surgical disease. The chief problem would be differentiating from anterior enteritis which might look similar but I would expect with AE an the early onset of fever and toxemia in combination with the presence of foul nasogastric tube reflux to help.
DrO

J Am Vet Med Assoc. 2007 Oct 15;231(8):1221-4.

Surgical management of small intestinal incarceration through the gastrosplenic ligament: 14 cases (1994-2006).

Jenei TM, Garcia-Lopez JM, Provost PJ, Kirker-Head CA.
Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.

Objective-To determine prevalence, clinical findings, and long-term survival rate after surgery associated with incarceration of the small intestine through the gastrosplenic ligament (ISIGL) in horses. Design-Retrospective case series. Animals-14 horses with ISIGL. Procedures-Medical records of horses with ISIGL examined between January 1994 and December 2006 were reviewed. Signalment, initial physical examination findings, results of abdominal fluid analysis, and clinical laboratory values were recorded, along with surgical findings, including segment of incarcerated intestine and surgical procedures performed. Long-term survival data were obtained through client interviews. Results-Clinical findings included small intestinal distention identified via rectal palpation (10/14 horses) or transabdominal ultrasonography (8/11), nasogastric reflux (4/14), and abnormal abdominal fluid (9/9). All horses required intestinal resection and anastomosis. Postoperative complications included adynamic ileus (5/14 horses), incisional infection (4/14), diarrhea (3/14), and laminitis (1/14). No breed or age predilection was detected, although geldings were at increased risk for ISIGL. Long-term survival rate was 79% (11/14 horses). Conclusions and Clinical Relevance-ISIGL was an uncommon cause of colicin this hospital population. With appropriate surgical intervention and postoperative management, the long-term prognosis for surgically treated horses was fair to good.
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