Roux-en-Y gastrojejunostomy and jejunojejunostomy for pyloric obstruction bypass in a horse and a foal

Gastric outflow obstruction in horses is a rare but challenging condition, often resulting from either congenital anomalies or acquired lesions such as chronic ulceration or pyloric polyps. Conventional surgical bypass procedures, including gastrojejunostomy (GJ) or gastroduodenostomy and less commonly duodenojejunostomy, can restore patency but may lead to postoperative complications.

To describe the presentation, surgical management, and postoperative outcome of two horses-an adult and a foal treated with Roux-en-Y gastrojejunostomy combined with a side-to-side jejunojejunostomy (JJO), emphasising the physiological and clinical advantages of this reconstruction compared with simple GJ.

Case report.

A 7-month-old Selle Français colt (250 kg) with ulcer-associated pyloric obstruction and an 11-year-old Dutch Warmblood gelding (600 kg) with pyloric polyps underwent exploratory laparotomy and Roux-en-Y pyloric bypass consisting of a side-to-side GJ and a JJO between the alimentary and biliary segments.

Both horses recovered uneventfully, with no reflux or resolution of reflux after surgery and return to feed within 72 h. No postoperative colic was observed, and follow-up findings were not suggestive of gastric distension after this time. Long-term follow-up (3 years in the colt, 8 months in the adult) revealed normal appetite, weight gain, and absence of recurrent signs.

Small number of cases.

Roux-en-Y gastrojejunostomy with JJO for pyloric bypass may provide a physiological diversion that maintains biliary continuity and may reduce complications observed with traditional GJ in horses. This configuration may represent a viable alternative to loop gastrojejunostomy for pyloric or duodenal bypass in equine pyloric obstruction, minimising bile reflux and gastric stasis.