A Potential Technique Error in Stapled Side-to-Side Anastomosis of the Small Intestine of the Horse

Anastomotic leakage was noted to occur at the junction of the staple lines used to create the stoma during small intestine side-to-side anastomosis. The anastomosis was performed in a clinical equine patient by joining the lateral surfaces of the intestinal segments using a gastrointestinal anastomosis stapling instrument (GIA). The cause of this problem was investigated by performing six anastomoses in the jejunum of a single anesthetized adult horse using the GIA; three anastomoses were created by joining the antimesenteric edges of the bowel segments and three anastomoses were created by joining the lateral surfaces of the bowel segments. Bowel segments were then dissected to examine the stoma and the integrity of the staple lines. No defects were detected in anastomoses performed by joining the antimesenteric edges. Anastomoses performed by joining the lateral surfaces all had a defect at the junction of the double rows of staples used to create the stoma. Such defects would have allowed leakage of fluid and/or ingesta at the anastomotic site.     

Survival after Small Intestine Resection and Anastomosis in Horses

The authors examined factors influencing survival in 140 horses that recovered from anesthesia after small intestinal resection between 1968 and 1986, using Kaplan-Meier estimated survival curves and the Cox proportional hazards regression model. Seventy-two horses (51%) died during the initial postoperative period, 19 horses (14%) died after discharge from the hospital, 33 horses (24%) were alive, and 16 horses (11%) were classified as censored. Mean age at surgery was 8 years. Horses 15 years of age or older, Arabians and Stallions, were overrepresented in the hospital population. The most common reason for resection was strangulation of bowel through a mesenteric rent. The mean and 50% median survival times were 1540 and 27 days, respectively. Horses admitted after January 1, 1980, had a significantly longer survival than those admitted before that time. Survival was longer after anastomosis of two small intestinal segments than after anastomosis of a small intestinal segment to the cecum; however, the length of bowel resected and the method of anastomosis had no demonstrable influence on survival. Of the variables studied, the heart rates at presentation and 24 hours after surgery were the most accurate predictors of survival.     

Abdominal Adhesions after Small Intestinal Surgery in the Horse

One hundred thirteen of 172 horses (66%) undergoing exploratory celiotomy for a small intestinal lesion survived 4 or more days after surgery. Intra-abdominal adhesions causing clinical problems requiring additional surgery or euthanasia were documented in 25 horses (22.1%). Problems developed in significantly more males than females. The most common initial small bowel lesion was ileal impaction (12 horses); 21 horses underwent small intestinal resection or bypass. However, there was no significant difference in the incidence of intra-abdominal adhesions between horses that underwent intestinal resection or bypass and those that did not. Only 4 of the 25 horses (16%) with problems associated with postoperative adhesions survived. The mean interval between surgical procedures or between the initial procedure and euthanasia for all horses was 84 days (range, 7–512 days; median, 25 days). However, 70% of the subsequent celiotomies were performed within 60 days of the previous surgery. The mean interval between celiotomies was 221 days (range, 9–512 days) for the survivors and 61 days (range, 7–358 days) for the nonsurvivors. These results indicated that most of the problems related to postoperative intra-abdominal adhesions occurred within 2 months of the initial small intestinal surgery. Furthermore, the earlier development of postoperative adhesions was associated with a poorer prognosis for survival.     

Incarceration of Small Intestine Through Rents in the Gastrosplenic Ligament in the Horse

Incarceration of the small intestine through a rent in the gastrosplenic ligament was diagnosed in five horses. Three affected horses were mature males and two were mature females. Persistent moderate to severe abdominal pain, elevated heart rate, congested mucous membranes, serosanguineous peritoneal fluid, and distended small intestine on rectal examination were consistent findings.
Exploratory celiotomy or gross necropsy examination showed the incarcerated intestine to be distal jejunum or ileum. In all horses, the intestine had herniated cranially through the rent in the gastrosplenic ligament. The incarcerated intestine was situated lateral to the stomach and craniolateral to the spleen. Three horses underwent exploratory celiotomy, and the incarcerated small intestine was reduced by gentle traction and then resected. Two of these horses were alive more than 2 years postoperatively without recurrence of signs of abdominal pain, and one was euthanized because of dehiscence of the abdominal incision. Two horses were euthanized without surgical intervention, and necropsy examination revealed a recent rent in the gastrosplenic ligament. This condition should be considered in the differential diagnosis of causes of small intestinal strangulation and obstruction in the horse.     

Bypass Surgery for the Treatment of Small Intestinal Ileus in the Horse A Report of Three Cases

The medical management of three horses with simple and strangulating small intestinal obstructions was unsuccessful and was therefore supported by surgical bypasses. Jejunocecostomies were used to treat horses with postoperative paralytic ileus that was unresponsive to medical management. These horses had abdominal pain, gastric distention, heart rate elevations greater than 60/minute, and small intestinal distention on rectal palpation. Two horses experienced weight loss which responded to bypass removal. The bypass effectively decreased the need for intravenous fluid administration and repeated nasogastric intubation.     

温度和中药对马离体小肠运动的影响

为了探究温度变化和中药对马离体小肠运动的影响,用生物信号处理系统监测了浴槽不同温度、中药单方(陈皮和枳实)和中药复方制剂对马离体小肠运动的影响。结果显示,浴槽温度从38℃降温到32℃过程中,小肠收缩频率和幅度减弱,张力增加(P0.05);当浴槽温度从32℃升温到38℃过程中,小肠收缩逐渐恢复;当浴槽温度从38℃升温到41℃过程中,小肠收缩幅度增加,收缩频率减慢(P0.05),再降温到38℃小肠收缩可恢复。复方浓度递增到128μL/mL时小肠收缩幅度和收缩张力同用药前指标比较,差异显著(P0.05)。陈皮单方浓度递增到32μL/mL时和64μL/mL时,小肠收缩张力同用药前张力比较差异分别显著(P0.05)和极显著(P0.01);浓度递增到64μL/mL时,小肠收缩幅度同用药前幅度比较,差异显著(P0.05)。枳实单方浓度递增到32μL/mL时,小肠收缩频率和张力同用药前指标比较差异分别显著(P0.05)和极显著(P0.01)。研究表明,温度降低可使马小肠平滑肌收缩加强,单味陈皮和枳实以及复方中药对马离体小肠均有抑制作用,提示这些中药方剂均有望用于临床缓解马匹肠痉挛。     

Jejunocolic Anastomosis for the Surgical Management of Recurrent Cecal Impaction in a Horse

A 5-year-old Thoroughbred gelding with recurrent cecal impaction refractory to medical management was treated with a side-to-side jejunocolic anastomosis. Cecal impaction did not recur after surgery. The horse gained weight and performed successfully for 14 months, but experienced three episodes of mild abdominal pain between 14 and 20 months after surgery. Mild cecal gas distention and firm ingesta in the colon were detected on rectal examination. The horse's feces remained soft after surgery, except during the colic episodes when dry, firm feces were passed.     

Leiomyoma of the Small Colon in a Horse

A leiomyoma of the small colon was discovered incidentally in a 4-year-old Thoroughbred gelding during colic surgery to correct large colon displacement. The mass and 20 cm of small colon were resected, and an end-to-end anastomosis was performed. A postoperative fecal impaction proximal to the anastomosis responded after 5 days to administration of intravenous fluids, analgesics, and stool softeners.     

Dorsal Laminectomy in the Horse II. Evaluation in the Normal Horse

Subtotal dorsal cervical laminectomy was performed on nine normal horses to evaluate positioning, refine the surgical technique, and assess the immediate and long-term effects of this procedure in the horse. Funkquist type B laminectomies were performed at various levels from C3-C4 to C6-C7. Absorbable gelatin sponge or autogenous nuchal fat was placed over the exposed dura mater. Surgery times varied from 2 to 3 hours, and all horses recovered without complication. Rapid primary intention wound healing occurred, with two horses showing neck pain. All remained neurologically normal. The horses were euthanized 6 weeks, 3 months, or 6 months postoperatively. Myelograms performed just prior to euthanasia demonstrated normal or expanded dye column widths. Necropsy revealed that all surgical sites had healed well. The laminectomy membrane was soft and pliable and could be easily separated from the underlying dura mater when fat was used as interpositional material. When gelatin sponge was used, the laminectomy membrane was firmly bonded to the dura. Spinal cords at the level of laminectomy appeared normal and moved freely within the vertebral canal. Histological evaluation of the laminectomy sites and associated spinal cord revealed no abnormalities attributable to the surgery. It was concluded that dorsal cervical laminectomy can be performed in horses without untoward sequelae. The procedure may be useful for the treatment of equine cervical compressive myelopathies.     

外源精胺对断奶仔猪小肠黏膜成纤维细胞因子-2蛋白质表达量及小肠发育的影响

本试验旨在研究外源精胺对断奶仔猪小肠黏膜成纤维细胞因子-2( FGF2)蛋白质表达量及小肠发育的影响。将9窝胎次和初生体重相近的7日龄“杜×长×大”哺乳仔猪随机分配到0、12和15 mg/kg外源精胺组,每组3窝。仔猪从7日龄起补饲相应的饲粮,21日龄断奶后继续补饲断奶前饲粮至28日龄结束。从每窝选2头接近平均体重的仔猪屠宰,采集小肠及黏膜样品,测定FGF2蛋白质表达量和小肠的发育状况。结果表明：1)12 mg/kg外源精胺组仔猪小肠黏膜FGF2蛋白质表达量分别高于0和15 mg/kg外源精胺组,但3个外源精胺组仔猪小肠黏膜FGF2蛋白质表达量之间无显著差异(P>0.05)。2)12和15 mg/kg外源精胺组仔猪小肠绒毛高度和宽度分别极显著大于0 mg/kg外源精胺组( P<0.01),而12 mg/kg外源精胺组仔猪十二指肠和空肠黏膜绒毛高度与隐窝深度比值( V/C )分别极显著高于0 mg/kg外源精胺组( P<0.01)。3)28日龄仔猪小肠黏膜蔗糖酶和麦芽糖酶活性随外源精胺添加量的增加而升高。由此可见,给7~28日龄仔猪连续补饲外源精胺能提高28日龄仔猪小肠黏膜FGF2蛋白质表达量、V/C和二糖酶活性。     

Transfer of Deep Circumflex Iliac Flaps to the Tarsus by Microvascular Anastomosis in the Horse

Eighteen deep circumflex iliac flaps were elevated in healthy adult horses. Four flaps survived well when elevated as islands, but five orthotopic flaps and nine heterotopic flaps transferred to the tarsus and face failed. Technical reasons could explain the failure of the orthotopic flaps, but not the heterotopic flaps. Failure of the heterotopic flaps was apparently caused by the no-reflow phenomenon.