Hanson R R, Wright J C, Schumacher J, Baird A N, Humburg J, Pugh D G
Department of Large Animal Surgery and Medicine, College of Veterinary Medicine, Auburn University, AL 36849-5522, USA.
Vet Surg. 1998 Nov-Dec;27(6):555-60. doi: 10.1111/j.1532-950x.1998.tb00531.x.
To evaluate the seasonal influence, signalment, type of hay consumed, clinical examination findings, and outcome after surgery for horses with ileal impaction.
A retrospective study.
Between 1988 and 1993, 28 horses had surgical correction of ileal impaction. There was a significantly higher rate of ileal impaction during the Fall (September-November, P = .0041 ). Mean duration of clinical signs of abdominal pain before referral was 15 hours. Transrectal palpation was used to localize the impaction in 11 horses. The ileal impaction was reduced by extraluminal massage aided by admixing of intestinal fluid oral to the impaction or injection of fluids intraluminally and then movement of the ingesta into the cecum alone in 24 horses. A total of 26 horses recovered from surgery; 24 horses were discharged from the hospital and eventually returned to previous use. Two horses had fatal postoperative complications: jejunocecostomy dehiscence and development of extensive small intestine adhesions after manual reduction of the impaction. One horse initially treated by manual reduction required jejunocecostomy twice for management of recurrent ileal impaction. Follow-up information was obtained for 21 horses, of which 20 were alive 1 year or longer after surgery. A total of 27 of 28 horses were fed Coastal Bermudagrass hay as the primary type of hay consumed. A total of 9 horses continued to be fed Coastal Bermudagrass hay as the only roughage source, whereas 6 horses were fed Coastal Bermudagrass with at least 50% other hay, and in 6 horses, Coastal Bermudagrass hay was entirely eliminated from the diet.
Ileal impactions can be successfully reduced by celiotomy and extraluminal massage and injection techniques to soften the ingesta for passage into the cecum without enterotomy or bypass techniques in most horses. Changes in weather and feeding practices in the Fall may account for an increased risk of ileal impaction in horses in the southeastern United States at that time of year.
评估回肠阻塞马匹的季节影响因素、特征、所食用干草类型、临床检查结果及手术后的转归。
一项回顾性研究。
1988年至1993年间，28匹马接受了回肠阻塞的手术矫正。秋季（9月至11月）回肠阻塞发生率显著更高（P = .0041）。转诊前腹痛临床症状的平均持续时间为15小时。11匹马通过直肠触诊来定位阻塞部位。24匹马通过在阻塞部位口服肠液混合辅助的腔外按摩、腔内注射液体，然后仅将食糜送入盲肠，使回肠阻塞得以缓解。共有26匹马术后康复；24匹马出院，最终恢复至先前的使用状态。两匹马出现致命的术后并发症：空肠盲肠吻合口裂开以及手动缓解阻塞后广泛小肠粘连的形成。一匹最初接受手动缓解治疗的马因复发性回肠阻塞需要两次空肠盲肠吻合术治疗。获得了21匹马的随访信息，其中20匹马术后存活1年或更长时间。28匹马中有27匹以海岸百慕大草干草作为主要食用的干草类型。共有9匹马继续仅以海岸百慕大草干草作为唯一的粗饲料来源，6匹马食用的海岸百慕大草干草至少占其他干草的50%，6匹马的饮食中完全不再含有海岸百慕大草干草。
在大多数马匹中，通过剖腹术、腔外按摩和注射技术可成功缓解回肠阻塞，无需肠切开术或旁路技术即可软化食糜以使其进入盲肠。秋季天气和饲养方式的变化可能是美国东南部马匹在一年中那个时候回肠阻塞风险增加的原因。
