Department of Clinical Science and Services, The Royal Veterinary College, Hatfield, UK.
Donnington Grove Veterinary Group, Newbury, UK.
J Vet Intern Med. 2023 Jul-Aug;37(4):1544-1551. doi: 10.1111/jvim.16735. Epub 2023 Jul 4.
Gastric impactions (GI) have been identified as primary lesions (lone GI; LGI) or associated with other intestinal lesions (concurrent GI; CGI). Anecdotally, CGI resolve more rapidly with a better prognosis than LGI.
To determine clinical, laboratory, and ultrasonographic findings, and short- and long-term survival in horses with GI. We hypothesized that LGI carries a worse prognosis than CGI.
Seventy-one horses from 2 referral hospitals (2007-2022).
Retrospective cohort study. Gastric impactions were defined as feed extending to the margo plicatus after ≥24 hours of fasting. Clinical, diagnostic and outcome findings were compared between LGI and CGI. Long-term survival was determined by a questionnaire.
Twenty-seven horses had LGI, 44 had CGI. Large intestinal lesions (32/44) were more common than small intestinal lesions (12/44). Concurrent gastric impactions resolved more slowly than LGI (LGI median 2 days, range 0-8; CGI median 4 days, range 1-10; P = .003). Short- (LGI 63%, 17/27; CGI 59%, 26/44; P = .75) and long-term survival (LGI 3.5 ± 1.9 years; CGI 2.3 ± 2.3 years; P = .42) were not significantly different. However, Lone gastric impactions were more likely to experience gastric rupture (LGI 29.6%, 8/27; CGI 11.4%, 5/44; P = .05). Lone gastric impactions were 8.7 times more likely to require dietary changes (LGI 72.7%, 8/11; CGI 25%, 4/16; 95% confidence interval [CI], 1.53-49.22; P = .01). Gastric impactions recurred in 21.7% (LGI, 6/20; CGI, 4/26; P = .23) of affected horses.
Lone gastric impactions and CGI present similarly with a comparable prognosis, but LGI are more likely to rupture. Long-term dietary changes are often necessary for horses with LGI.
胃内异物（GI）被认为是原发性病变（单独 GI；LGI）或与其他肠道病变同时存在（并发 GI；CGI）。据报道，CGI 比 LGI 更快缓解，预后更好。
确定马 GI 的临床、实验室和超声检查结果以及短期和长期生存情况。我们假设 LGI 的预后比 CGI 差。
来自 2 家转诊医院的 71 匹马（2007-2022 年）。
回顾性队列研究。胃内异物定义为禁食≥24 小时后饲料延伸至黏膜褶。比较 LGI 和 CGI 之间的临床、诊断和结局发现。通过问卷调查确定长期生存情况。
27 匹马有 LGI，44 匹马有 CGI。大肠病变（32/44）比小肠病变（12/44）更常见。并发胃内异物的缓解速度比 LGI 慢（LGI 中位数 2 天，范围 0-8；CGI 中位数 4 天，范围 1-10；P=0.003）。短期（LGI 63%，17/27；CGI 59%，26/44；P=0.75）和长期生存（LGI 3.5±1.9 年；CGI 2.3±2.3 年；P=0.42）无显著差异。然而，单独的胃内异物更有可能发生胃破裂（LGI 29.6%，8/27；CGI 11.4%，5/44；P=0.05）。单独的胃内异物更有可能需要改变饮食（LGI 72.7%，8/11；CGI 25%，4/16；95%置信区间[CI]，1.53-49.22；P=0.01）。21.7%（LGI，6/20；CGI，4/26；P=0.23）受影响的马再次发生胃内异物。
单独的胃内异物和 CGI 表现相似，预后相当，但 LGI 更有可能破裂。LGI 马通常需要长期改变饮食。
