Small intestinal herniation through the epiploic foramen: 53 cases (1987-1993)

The incidence of epiploic entrapment of the small intestine in horses undergoing celiotomy for colic was 5%. The condition was more prevalent in older (mean 9.81 years) gelding and Thoroughbred horses. Preoperative peritoneal protein level was a good prognostic indicator as it was significantly greater in the nonsurvivor (39.4 +/- 5.10) group than in the survivor group (26.6 +/- 14.0) (P<0.05). Abdominal ultrasonography allowed earlier diagnosis and surgical intervention in nonpainful cases with inconclusive rectal findings. Surgery was completed in 46 horses and 44 horses recovered from anaesthesia. Nine horses were either subjected to euthanasia in surgery (7 horses) or died in recovery (2 horses). Repeat laparotomies were pursued in 27% (12/44) of the horses. Seven horses (16%) showed post operative adynamic ileus which was the most common post operative complication. The incidence (6%) of adhesion formation was lower than previously reported. Other post operative complications included gastric ulceration, liver disease, diarrhoea and weight loss. Short and long term survival rates were 79% (35/44) and 70% (31/44) respectively. Improved rates were attributed to earlier referral and diagnosis and prompt surgical intervention. The aggressive use of repeat celiotomy and a more effective treatment of the endotoxic horse in the perioperative period contributed to survival.