Department of Equine Clinical Science, Institute of Veterinary Science, University of Liverpool, Neston, UK.
Equine Vet J. 2024 Nov;56(6):1201-1208. doi: 10.1111/evj.14014. Epub 2023 Oct 3.
Mesodiverticular bands (MDBs) are an embryonic remnant of the vitelline artery. Information about the clinical significance of equine MDBs is currently limited.
To report the clinical features, surgical findings and outcomes of horses undergoing exploratory laparotomy where a MDB was identified.
Retrospective case series.
Case records of horses undergoing exploratory laparotomy for colic over a 14-year period (2009-2022) were reviewed. MDBs identified at laparotomy were classified as the primary or contributory cause of abdominal pain, or as incidental.
MDBs were identified in 40/1943 horses (2.1%) and 15 were primary (32.5%), 10 contributory (25%) and 15 incidental (32.5%). Horses with primary MDBs (median 2 years, IQR 1-12) were significantly younger than horses with incidental MDBs (median 8 years, IQR 6-16; P = 0.01). MDBs were more likely to be incidental if located in the mid-jejunum (5/5) (P < 0.001) or where a mesenteric pocket was absent (11/15) (P = 0.01). Primary MDBs caused extra-mural obstruction due to mesenteric shortening (n = 4), small intestinal entrapment within the MDB pocket (n = 5) or in an adjacent mesenteric rent (n = 4), and volvulus around the MDB (n = 2), with intestinal resection required in 8/15 cases. For horses with primary MDBs, survival to hospital discharge was 60% overall (9/15) and 75% for horses that stood following anaesthesia (9/12) with 88.9% of cases discharged from hospital (8/9) surviving >1 year. Excision of MDB tissue was not associated with complications but 3/4 non-incidental MDBs left in situ required relaparotomy to treat MDB-associated colic.
Retrospective single centre data.
Most MDBs in horses undergoing surgical treatment of colic in this population were not incidental. MDB-associated colic was most commonly classified as strangulating obstruction, but non-strangulating extra-mural compression was also identified. Excision of MDB tissue should be undertaken where possible, particularly in non-incidental cases.
中肠憩室带（MDBs）是脐动脉的胚胎残余物。目前关于马属动物 MDB 的临床意义的信息有限。
报告在剖腹探查中发现 MDB 的马的临床特征、手术发现和结果。
回顾性病例系列。
回顾 14 年期间（2009-2022 年）因腹痛接受剖腹探查的马的病例记录。在剖腹探查中发现的 MDB 被分为腹痛的主要或促成原因，或为偶然发现。
40/1943 匹马（2.1%）中发现 MDB，其中 15 个为原发性（32.5%），10 个为继发性（25%），15 个为偶然发现（32.5%）。原发性 MDB 马（中位数 2 岁，IQR 1-12）明显比偶然发现 MDB 马（中位数 8 岁，IQR 6-16；P=0.01）年轻。如果 MDB 位于中肠（5/5）（P<0.001）或肠系膜袋缺失（11/15）（P=0.01），则更有可能为偶然发现。原发性 MDB 引起肠外阻塞，原因是肠系膜缩短（n=4）、小肠在 MDB 袋内嵌顿（n=5）或在相邻的肠系膜裂口（n=4）、以及 MDB 周围的扭转（n=2），需要进行 8/15 例肠切除术。对于原发性 MDB 马，整体存活率为 60%（9/15），麻醉后站立的马存活率为 75%（9/12），88.9%（8/9）的病例出院后存活>1 年。MDB 组织切除与并发症无关，但 3/4 例未切除的非偶然 MDB 需再次剖腹探查以治疗与 MDB 相关的腹痛。
回顾性单中心数据。
在该人群中接受外科治疗腹痛的马中，大多数 MDB 不是偶然发现的。与 MDB 相关的腹痛最常见的分类为绞窄性梗阻，但也发现了非绞窄性肠外压迫。如果可能，应进行 MDB 组织切除，特别是在非偶然情况下。
