Entrapment of a jejunocecostomy anastomosis in the epiploic foramen in a horse

Abstract

A mare aged 9 years underwent surgical correction of a small intestinal volvulus using a side-to-side, hand-sewn jejunocecal anastomosis. Nine months after the jejunocecostomy, the horse developed colic signs and ultrasonographic examination revealed gas in the large colon in the upper right flank region and several enlarged loops of the small intestine in the lower right flank area. The differential diagnosis was right dorsal displacement of the large colon or small intestinal strangulation. The exploratory celiotomy found epiploic foramen entrapment (EFE) of the jejunocecostomy anastomosis, including parts of the distal jejunum and cecum. Manual reduction of herniation of the bowel in the epiploic foramen (EF) was impossible and the horse was euthanized. The postmortem gross finding revealed the enlarged edematous at the distal end of the jejunum and the initial body portion of the cecum had passed into the EF in the right-to-left (antegrade) direction. To the authors’knowledge, this is the first report of the antegrade epiploic foramen entrapment of a jejunocecostomy bowel part and this may be one of the complications encountered during the long-term survival period of a surgical jejunocecostomy in horses.