Sonographic Evaluation of Coprostatic Impaction with Sand and Ingesta in Draft Equids

Abstract

Background: Impaction of colons is a major cause of deaths in equines; therefore the objective of the current study was to perform the detailed ultrasonographic examination of equids suffering from abdominal discomfort and to identify which measurable parameters were important in reaching a diagnosis of small intestinal abnormality and determining treatment options. Methods: In this study twenty five equids (age 10-13 years) with history of cessation of defecation ranging from 2-4 days were subjected to sonography. Result: The impaction of left ventral colon in all animals was imaged as hyperechoic intraluminal structure casting a strong acoustic shadow with loss of normal sacculations, edema, increase in wall thickness and absence of peristaltic activity. Findings giving an indication of sand colic were the flattening of left ventral colon wall against the ventral body wall with loss of normal sacculations, peristaltic activity, presence of small pinpoint hyperechoic structures on the mucosal surface seen casting small acoustic shadows and reverberation artifacts in different directions were highly suggestive of sand impaction. In all animals the loops of small intestine were observed in transverse as well as longitudinal sections as hypermotile distended with fluidy ingesta and hyperechoic feed particles swirling inside that fluidly ingesta. The presence of dilated multiple loops of intestine in a single scanning area was a consistent feature of left ventral colon impaction. Hence detailed ultrasonographic examination was useful to delineate normal and abnormal conditions and to distinguish between true and false colic which provided an important diagnostic lead in management of affections of left ventral colon.