Equine colic associated with small intestinal epiploic foramen entrapment

Equine colic associated with small intestinal epiploic foramen entrapment
Vet J. 2021 Mar;269:105608.
Authors
Thomas van Bergen 1 , Peter Wiemer 2 , Ann Martens 3
Affiliations

1 Clinique Equine Acy-Romance, 08300 Acy-Romance, France. Electronic address: thomas.vanbergen@clinique-acy.com.
2 De Lingehoeve Diergeneeskunde, Lienden, The Netherlands; Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Belgium.
3 Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Belgium.

Abstract

Intestinal epiploic foramen entrapment (EFE) is an important differential diagnosis in horses with colic, but disappointing short- and long-term outcomes are reported in the scientific literature. Many horses are euthanased during surgery due to a predicted poor prognosis or due to uncontrollable intraoperative haemorrhage. The ileum is involved in the majority of cases. Several risk factors for the development of EFE are described; crib-biting/windsucking being the most important one. The recurrence rate of EFE is low despite the described risk factors, probably due to spontaneous closure of the EF after EFE colic surgery in about 40% of the cases. Safe laparoscopic techniques to obliterate the EF preventively in horses at risk or as part of surgical management of EFE at laparotomy are described. Methods for improved outcomes including utilising recently gained anatomical insights of the region while manipulating entrapped intestines, critical revision of anastomosis techniques and avoiding the occurrence of post-operative reflux are discussed.

Keywords: Colic; Epiploic foramen entrapment; Horse; Small intestine.