J Am Vet Med Assoc. 2020 Jul 15;257(2):189-195. doi: 10.2460/javma.257.2.189.
To describe outcome and complications after large intestinal trocarization in equids with colic and identify factors associated with nonsurvival and clinically relevant peritonitis (CRP).
228 (198 horses, 24 ponies, and 6 donkeys and mules) equids with colic that underwent large intestinal trocarization.
Medical records from 2004 through 2015 were reviewed for equids with colic that underwent large intestinal trocarization. Factors associated with nonsurvival in all (ie, surgically and medically treated) equids and with CRP in medically only treated equids were identified. Medically only treated equids with a high peritoneal fluid cell count (ie, > 10,000 cells/μL) after large intestinal trocarization were classified as having CRP if they met ≥ 2 of the following clinical criteria: anorexia, fever, lethargy, abnormal oral mucous membrane color, abnormal WBC count, or high blood fibrinogen concentration (> 5 g/L).
Transabdominal large intestinal trocarization was performed in 190 (83%) equids, transrectal trocarization in 17 (7%), and both procedures in 21 (9%). Of 228 equids, 167 (73%) survived to hospital discharge. None died or were euthanized because of complications from large intestinal trocarization. Nonsurvival was associated with an increasing number of trocarization procedures and diagnosis of a large intestinal strangulating lesion. A diagnosis of nephrosplenic ligament entrapment of the large colon decreased the odds of nonsurvival. Twelve of 60 (20%) equids that received medical treatment only had CRP following large intestinal trocarization.
Large intestinal trocarization could be considered for equids with colic and large intestinal gas distension. More than one trocarization procedure was associated with an increase in nonsurvival, which should be considered for equids for which consent for surgery has been obtained.
描述大肠穿刺在伴有腹痛的马属动物中的结果和并发症，并确定与非存活和临床相关腹膜炎（CRP）相关的因素。
228 例（198 匹马、24 匹矮种马、6 匹驴和骡子）伴有腹痛的马属动物进行了大肠穿刺。
回顾了 2004 年至 2015 年接受大肠穿刺的伴有腹痛的马属动物的病历。确定了所有（即手术和药物治疗）马属动物非存活和仅药物治疗马属动物 CRP 的相关因素。如果接受大肠穿刺后腹膜液细胞计数高（即>10,000 个细胞/μL）的仅药物治疗马属动物符合以下 2 项以上临床标准，则将其归类为 CRP：食欲不振、发热、嗜睡、口腔黏膜颜色异常、白细胞计数异常或高血纤维蛋白原浓度（>5g/L）。
190 例（83%）马属动物行经腹大肠穿刺，17 例（7%）经直肠穿刺，21 例（9%）同时行两种操作。228 例马属动物中，167 例（73%）存活至出院。无因大肠穿刺并发症而死亡或安乐死的病例。非存活与穿刺次数的增加和诊断为大肠绞窄性病变有关。诊断为肾脾韧带嵌顿结肠可降低非存活的几率。仅接受药物治疗的 60 例马属动物中有 12 例在大肠穿刺后发生 CRP。
对于伴有腹痛和大肠气胀的马属动物，可以考虑进行大肠穿刺。多次穿刺与非存活几率增加有关，对于已获得手术同意的马属动物应考虑这一点。
