Strangulating lesions of the small intestine associated with the greater omentum in horses: 32 cases

• Published in: Equine veterinary education Vol. 34; no. 10; pp. e451 - e460
• Main Authors: Storms, N., Salciccia, A., Grulke, S., Barbazanges, P., Detilleux, J., Rebière, G.
• Format: Journal Article Web Resource
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc 01-10-2022; Equine Veterinary Journal Ltd
• Subjects: Anesthesia; Colic; Equine; horse; Horses; Intestine; Lesions; Life sciences; Lipoma; Médecine vétérinaire & santé animale; Omentum; Regression analysis; Regression models; Risk analysis; Risk factors; Sciences du vivant; Small intestine; Strangulation; Survival; Veterinary medicine & animal health
• ISSN: 0957-7734; 2042-3292; 2042-3292
• DOI: 10.1111/eve.13536

Summary
Background
Strangulating lesions of the small intestine involving the greater omentum (SSIGOs) have only rarely been reported. Furthermore, information pertaining to clinical descriptions, surgical findings and outcome is lacking.
Objectives
The objective of this study was to describe the prevalence, clinical presentation, surgical findings, postoperative outcome and risk factors associated with SSIGOs.
Study design
This is a retrospective case series of 32 horses with a diagnosis of SSIGOs.
Methods
Data from hospital records of horses identified with SSIGOs between 2005 and 2020 including signalment, clinical findings at presentation, initial laboratory results, surgical findings, surgical procedures performed and postoperative survival were analysed. The prevalence of SSIGOs was determined. SSIGO was compared with small intestinal strangulating and nonstrangulating lesions and other types of colic to identify potential risk factors among signalment data and to determine outcome, using multiple logistic regression models.
Results
SSIGOs were present in 2.3% (32/1413) of all horses undergoing exploratory laparotomy for colic, 4.7% of all horses with primary small intestinal lesions (32/683) and 5.6% of strangulating small intestinal lesions (32/570). Surgical findings included primary strangulation by the greater omentum with or without involvement of a lipoma‐like mass originating from the greater omentum (15/32 [47%]), adhesions involving the greater omentum leading to strangulation of the small intestine (14/32 [44%]) and small intestine incarceration through an omental rent (3/32 [9%]). The short‐term survival rate defined as survival until discharge was 53% (17/32) considering all SSIGO cases, and 85% (17/20) for SSIGO cases recovered from anaesthesia. Risk factors identified were increasing age and year of surgery.
Main limitations
The limitations of this study are retrospective study design and the limited number of SSIGO cases reflecting the rarity of this condition.
Conclusions
Numerous anatomical configurations of SSIGO exist, but clinical presentation is similar to other strangulating small intestinal lesions. Although uncommon, SSIGOs should be considered a potential cause of small intestine strangulation.