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1.
Objectives: To determine (1) the short‐ (to hospital discharge) and long‐ (>6 months) term survival, (2) factors associated with short‐term survival, and (3) the perioperative course for horses with resection and anastomosis of the descending colon. Study Design: Multicentered case series. Animals: Horses (n=43) that had descending colon resection and anastomosis. Methods: Medical records (January 1995–June 2009) of 7 equine referral hospitals were reviewed for horses that had descending colon resection and anastomosis and were recovered from anesthesia. Retrieved data included history, results of clinical and clinicopathologic examinations, surgical findings, postsurgical treatment and complications, and short‐term survival (hospital discharge). Long‐term survival was defined as survival ≥6 months after hospital discharge. Results: Of 43 horses, 36 (84%) were discharged from the hospital. Twenty‐eight of 30 horses with follow‐up information survived ≥6 months. No significant associations between perioperative factors and short‐term survival were identified. Lesions included strangulating lipoma (n=27), postfoaling trauma (4), infarction (4), intraluminal obstruction (2), and other (6). Common postoperative complications included fever and diarrhea. During hospitalization 7 horses were euthanatized or died because of septic peritonitis (3), endotoxemia (3), and colic and ileus (1). Conclusions: Descending colon resection and anastomosis has a favorable prognosis for hospital discharge and survival ≥6 months. The most common cause of small colon incarceration was strangulating lipoma. Clinical Relevance: Complications include postoperative fever and diarrhea but the prognosis is good after small colon resection and anastomosis.  相似文献   

2.
Reasons for performing study: Although experimental studies have demonstrated differences in performance between methods for handsewn jejunojejunostomy in horses, information on clinical results after different methods of anastomosis are rare. Hypothesis: A continuous Lembert pattern wrapped in a carboxymethylcellulose and hyaluronate membrane would perform better than an interrupted Lembert pattern for jejunojejunostomy in horses. Methods: Data was reviewed on 32 horses that underwent jejunojejunostomy from 1993–2002. Kaplan‐Meier analyses and rates for post operative colic and death were used to compare outcomes after an interrupted Lembert pattern (15 horses with strangulating lesions and 5 horses with nonstrangulating lesions) and a continuous Lembert pattern with membrane (12 horses with strangulating diseases). Results: None of the 32 horses had post operative ileus or post operative endotoxaemia. One horse with a continuous pattern required a repeat celiotomy for anastomotic impaction. Short‐term survivals for the interrupted Lembert were 100% (nonstrangulating lesions) and 93% (strangulating lesions) and for the continuous pattern 92% (all strangulating). Long‐term rates for mortality and colic episodes were less for the continuous Lembert pattern with membrane compared with the interrupted Lembert for strangulating lesions (P<0.05) and were less for strangulating lesions than for nonstrangulating lesions (P<0.05). For strangulating lesions, Kaplan‐Meier analyses yielded a survival probability of 70% for up to 9 years after the interrupted Lembert pattern and 80% for up to 5 years for the continuous Lembert pattern. Conclusions and relevance: Both Lembert patterns performed well in clinical use, although the continuous pattern with the carboxymethylcellulose and hyaluronate membrane had superior long‐term outcomes with less colic and mortality from colic.  相似文献   

3.
Reasons for performing study: If untreated, caecal impaction may progress to rupture of the caecum and reports of long‐term outcome for horses undergoing surgery for caecal impaction are required. Objectives: To describe short‐ and long‐term complication rates for horses undergoing surgery for caecal impaction in an otherwise life‐threatening gastrointestinal condition. Methods: Case records were reviewed for horses undergoing surgery for caecal impaction. Horses were included in the study if an abnormally large, fluid‐distended or feed‐impacted caecum was the primary diagnosis at surgery and excluded if the caecum had already ruptured upon opening the abdomen, necessitating euthanasia. Short‐term follow‐up data were obtained from clinical records; and included complications, repeat celiotomy and survival to discharge. Long‐term survival was defined as survival for >1 year post operatively. Long‐term follow‐up data were obtained through telephone interviews with owners and referring veterinary surgeons. Survival, occurrence of post operative colic and subsequent use of the horse were recorded. Results: Twenty horses underwent surgery for caecal impaction: 16 horses underwent caecal bypass (typhlotomy and removal of caecal contents, ileal transection followed by ileocolostomy); 3 underwent typhlotomy alone; and one horse underwent typhlotomy followed by a second procedure where caecal bypass was performed. Five horses (25%) were admitted for colic evaluation with primary caecal impactions, in 10/20 (50%) of cases the impaction was secondary to previous orthopaedic surgery and in 5/20 (25%) caecal impaction was identified at repeat celiotomy following a previous colic surgery. Sixty‐five percent (13/20) of horses survived to discharge; 11/13 (85%) of horses discharged survived long term; 100% (3/3) horses that received typhlotomy alone were discharged and survived long term. Conclusions: The prognosis following caecal impaction surgery is fair, if the horse survives to discharge then prognosis for long‐term survival is good. Potential relevance: Surgery for caecal impaction carries a fair prognosis for a potentially life threatening disease, in particular where caecal dysfunction is suspected.  相似文献   

4.
OBJECTIVE: To evaluate the relationship of colonic luminal pressure (CLP) measurements to outcome in horses with large colon volvulus (LCV) after either manual correction or large colon resection and anastomosis (LCRA). STUDY DESIGN: Retrospective study. ANIMALS: Horses (n=57) that had LCV. METHODS: Records for horses with LCV (March 1997-December 2003) were reviewed. Inclusion criteria were strangulating LCV proximal to the cecocolic ligament (>270 degrees), recorded CLP, and successful recovery from anesthesia. CLP measurements and survival/mortality rates were compared between horses that had manual correction (M) or LCRA (R). RESULTS: Of 57 horses, 27 had M and 30 had LCRA. For group M, CLP measurements had a sensitivity of 0.60 and specificity of 0.77 for predicting survival, whereas for group R, sensitivity was 0.50 and specificity was 0.54. CONCLUSION: In our LCV population, elevated CLP measurements had poor accuracy for predicting outcome in horses after surgical correction, especially after LCRA. CLINICAL RELEVANCE: CLP measurements based on a single hospital population of horses with LCV should be used with caution for other hospital populations of LCV. CLP may be only one of many variables needed for predicting outcome of horses with strangulating LCV, especially after LCRA.  相似文献   

5.
Objective: To compare incidence of postoperative complications and survival of horses that had surgery for enterolithiasis of the ascending (AC) or descending (DC) colon. Study design: Case series Animals: Horses (n=236) that had celiotomy for AC (n=97) or DC (n=139) enterolithiasis. Methods: Medical records (1999–2005) were reviewed for signalment, presenting clinical signs, surgical findings, postoperative complications, and short‐term survival until discharge. Information on performance and survival ≥1 year was obtained by telephone or mailed questionnaire. Results: Number of postoperative complications did not differ between groups (P=.76). The most frequently identified short‐term complications for all horses were incisional problems, gastric ulceration, ileus, diarrhea, fever, and anorexia. Horses with DC enteroliths had a significantly higher incidence of anorexia (P=.04) and fever (P=.01). The most common complications after hospital discharge were incisional problems, laminitis, weight loss, and colic. Although more DC horses were euthanatized intraoperatively (P=.02), no differences were detected for horses that survived until discharge (P=.18) or ≥1 year after discharge (P=.47). Conclusions: Number or type of postsurgical complications or survival after surgery was not influenced by enterolith location and horses have a favorable prognosis for long‐term survival after enterolith removal, regardless of site of obstruction in the colon. Clinical Relevance: Incidence of postoperative complications and survival are not affected by the site of enterolith obstruction in the colon.  相似文献   

6.
Reason for performing study: Owners and veterinarians are often concerned about mortality of geriatric horses following colic surgery. Objective: To compare treatment, diagnosis and short‐term survival for geriatric compared to mature nongeriatric horses with colic. Methods: Medical records of horses admitted with a presenting complaint of colic between 2000 and 2006 were reviewed. Geriatric horses were aged ≥16 years (n = 300) and subcategorised as age ≥20 years (n = 134). Mature nongeriatric horses were age 4–15 years (n = 300). Information obtained included medical (included horses subjected to euthanasia without surgery) vs. surgical management, lesion location, type and classification, surgical procedures performed and short‐term survival. Data were analysed using a Chi‐squared test or an analysis of variance. Level of significance was P<0.05. Results: The overall short‐term survival of geriatric horses was lower than that for mature horses (59 vs. 76%, respectively). The survival of medically managed geriatric horses was lower than that for mature horses (58 vs. 80%, respectively). The survival of surgically managed geriatric horses was not different to that for mature horses (59 vs. 70%, respectively) except for geriatric horses age ≥20 years (53%). There was no difference in survival between geriatric and mature horses with small (86 and 83%, respectively) or large (78 vs. 70%, respectively) intestinal strangulating lesions or those undergoing jejunojejunostomy (75 vs. 70%, respectively). Geriatric horses with a large colon simple obstruction had a lower survival compared to mature horses (80 vs. 97%, respectively). Conclusions and potential relevance: The survival of geriatric horses with a strangulating lesion or requiring jejunojejunostomy was not different to that for mature horses. Geriatric horses presenting with colic were more likely than mature horses to be subjected to euthanasia without surgery (i.e. lower survival with medical treatment). Geriatric horses undergoing surgery for a large colon simple obstruction had a lower survival than mature horses.  相似文献   

7.
Ten normal horses had approximately 95% of the length of the large colon resected with a side-to-side anastomosis between right ventral and right dorsal colon performed with surgical stapling equipment. Four horses died shortly after surgery of colitis (1 horse) or failure of the TA 90 transection staple line (3 horses). Another horse died 4 months after surgery from disseminated streptococcal infection but had recovered well from the colon resection. Five horses survived long term (18 months) with no clinical evidence of adverse effects of the resection. Surviving horses had weight loss and soft fecal consistency for 3 to 12 weeks after surgery but returned to preoperative values within 12 months. At a second surgery 1 year later (5 horses) or at necropsy 4 months later (1 horse), fibrous omental adhesions were present over the transection staple line in four horses and over the anastomotic staple line in two horses. Omental adhesions to the everted staple line were moderate but not associated with any clinical sequellae. An incisional hernia was present in one horse. The anastomotic stomata measured between 8 and 9 cm, which was 60% of the size of the original surgically created stomata. Failure of the transection staple line occurred in the first three of five horses in which the procedure was attempted due to improper configuration of the staples or crushing of the tissue between the staples. Experience corrected this complication.  相似文献   

8.
Objectives— To determine the relationship between plasma lactate concentration and colonic viability and survival in horses with ≥360° volvulus of the ascending colon.
Study Design— Retrospective study.
Animals— Horses (n=73) with ≥360° volvulus of the ascending colon.
Methods— Medical records (January 2000–November 2005) of all horses examined for colic at Michigan State University Veterinary Teaching Hospital were reviewed. Horses were included only if plasma lactate concentration was measured preoperatively and a diagnosis of ≥360° volvulus of the ascending colon was confirmed by surgery or necropsy. Non-survivors were only included if the ascending colon was evaluated histopathologically. Logistic regression analysis was used to model the relationship between lactate, colonic viability, and survival.
Results— Of 73 horses, 61 were discharged. Mean (±SD) plasma lactate concentration was significantly lower in survivors (2.98±2.53 mmol/L) compared with non-survivors (9.48±5.22 mmol/L; odds ratio [OR]=1.628, 95% confidence limit [CI]=1.259–2.105). Plasma lactate concentration was significantly lower in horses with a viable colon (3.30±2.85 mmol/L) compared with horses with a non-viable colon (9.1±6.09 mmol/L; OR=1.472, 95% CI=1.173–1.846). Plasma lactate concentration <6.0 mmol/L had a sensitivity of 84% and a specificity 83% for predicting horse survival.
Conclusions— Our results demonstrate a strong association between plasma lactate concentration at the time of hospital admission and outcome in horses with ≥360° volvulus of the ascending colon.
Clinical Relevance— Plasma lactate concentration may help predict colonic viability and horse survival after ascending colon volvulus in horses.  相似文献   

9.
Colopexy of the Left Large Colon to the Right Large Colon in the Horse   总被引：1，自引：0，他引：1  
Three colopexy techniques were examined in 11 normal horses to determine which would prevent recurrence of targe colon displacement and volvulus. The medial free band of the left ventral colon was sutured to the medial free band of the right ventral colon (technique A). The free band of the left dorsal colon was sutured to the free band of the right dorsal colon (technique B). In technique C, both the ventral and dorsal colon were sutured as in techniques A and B, and the pelvic flexure was sutured to the mesocolon between the right dorsal and right ventral colon. Absorbable (surgical gut) and nonabsorbable (polypropylene) suture material were compared.
One horse from each group was euthanized 2 weeks and 6 months after surgery. The position of the colon and the integrity of the colopexy were examined. At necropsy, attempts were made to produce displacement and volvulus of the colon. In the remaining horses, exploratory celiotomy 1 year after surgery was used to examine the integrity of the colopexy.
Although all horses initially lost weight after surgery, all but one began gaining weight 2 to 4 weeks later and had attained their preoperative weight by 6 months. The horse that continued to lose weight was euthanized 2 months after surgery. Numerous small colon, omental, and large colon adhesions were found at necropsy.
For all colopexy techniques, the colopexy adhesion remained short and intact at polypropylene suture sites. At surgical gut sites, the adhesion had lengthened by 6 months and was absent at 1 year. At necropsy, all colopexies prevented manual displacement of the large colon and volvulus of the colon at the sternal and diaphragmatic flexures. The colopexies did not prevent manual creation of volvulus at the base of the colon. Technique A was the easiest to perform.  相似文献   

10.
Objective— To report inguinal herniation of the ascending colon in a Standardbred colt. Study Design— Case report. Animals— A 6‐month‐old Standardbred colt. Methods— The colt underwent surgical exploration of the hernia with large colon resection and anastomosis. Results— A successful large colon resection and anastomosis was completed, however, the colt was euthanatized at the end of surgery upon owner request. Conclusions and Clinical Relevance— Although uncommon, indirect inguinal herniation of the ascending colon can occur in young horses.  相似文献   

11.
OBJECTIVE: To compare postoperative complications, short- and long-term survival, and surgical times for hand-sewn end-to-end (EE), stapled functional end-to-end (FEE), and stapled side-to-side (SS) anastomotic techniques for jejunal resection in horses. DESIGN: Retrospective study. ANIMALS: 59 horses. PROCEDURE: Medical records were reviewed to obtain signalment, diagnosis, treatment, and outcome for horses that underwent jejunojejunostomy in our hospital. Only horses that recovered from anesthesia were included in the study. RESULTS: Among the 59 horses, there were 33 EE, 15 FEE, and 11 SS anastomoses. No difference was found in duration of surgery among the 3 techniques. The most common postoperative complications were colic episodes (56%), ileus (53%), diarrhea (20%), and adhesions (15%). Horses with SS anastomosis had a significantly shorter duration of postoperative ileus than the EE group did. No significant difference in duration of postoperative ileus was found among the other groups. No difference was found among the 3 anastomotic techniques in regard to survival rate at the time of discharge, 6 months after surgery, or 1 year after surgery. Overall survival rates after jejunal anastomosis were 88% at the time of discharge, 65% at 6 months after surgery, and 57% at > or = 1 year after surgery. CONCLUSIONS AND CLINICAL RELEVANCE: The hand-sewn EE, stapled FEE, and stapled SS anastomotic techniques should be considered equivalent methods for small intestinal anastomosis in the horse. However, the stapled SS technique may be preferred because of possible decreased duration of postoperative ileus.  相似文献   

12.
Reasons for performing study: The pattern of long‐term survival and specific factors associated with long‐term survival have not previously been evaluated in horses with a strangulating large colon volvulus (LCV). Objectives: To provide data on the long‐term survival of horses with LCV and to identify pre‐, intra‐ and post operative variables associated with survival. Methods: Clinical data and long‐term follow‐up information were obtained from 116 horses with a strangulating LCV (≥360°) undergoing general anaesthesia. Two multivariable Cox proportional hazards models for post operative survival time were developed: Model 1 included all horses and evaluated preoperative variables and Model 2 included horses that survived anaesthesia and evaluated pre‐, intra‐ and post operative variables. Results: The study population comprised 116 horses. Eighty‐nine (76.7%) survived general anaesthesia. Of these, the percentage that survived until discharge, to one year and to 2 years was 70.7%, 48.3% and 33.7%, respectively. Median survival time for horses that survived general anaesthesia was 365 days. In Model 1 increased preoperative packed cell volume (PCV) was significantly associated with reduced post operative survival (hazard ratio [HR] 1.08, 95% confidence interval [CI] 1.05–1.11). However, this effect changed over time. In Model 2 abnormal serosal colour intraoperatively (HR 3.61, 95% CI 1.55–8.44), increased heart rate at 48 h post surgery (HR 1.04, 95% CI 1.02–1.06), and colic during post operative hospitalisation (HR 2.63, 95% CI 1.00–6.95), were all significantly associated with reduced post operative survival. Conclusions: Survival time in horses with a LCV was associated with preoperative PCV, serosal colour, heart rate at 48 h post operatively and colic during post operative hospitalisation. Potential relevance: This study provides evidence‐based information on the long‐term survival of horses with LCV and identifies parameters that may assist decision‐making by clinicians and owners.  相似文献   

13.
Postoperative complications and mortality can occur many weeks or months after colic surgery. We are interested in the long-term outcome of these cases. This study documents patterns of mortality and morbidity among 341 horses that recovered from colic surgery March 1998-August 2000. The progress of each horse was rigorously followed by periodic telephone and postal questionnaires. Event time data were recorded for each animal and a total of 321 horse years of survival, together with death from all causes, colic-related death and various postoperative complications. Postoperative survival (of all horses excluding grass sickness cases) was triphasic over the first 600 days and there was marked mortality in the first 10 days postoperatively. The probability of survival postoperatively decreased to 0.87 by 10 days, 0.82 by 100 days and declined slowly to 0.75 at 600 days. Horses suffering from epiploic foramen entrapment had a significantly reduced probability of postoperative survival (RR = 2.1, P = 0.033). The causes of death for 104 horses that died postoperatively and the prevalence of postoperative complications are recorded for the study population. Postoperative colic was the most prevalent complication with 100 horses (29%) suffering one or more episodes. However, only 16 horses (4.6%) suffered 3 or more episodes. The incidence of postoperative colic was 0.55 episodes/horse year at risk. This study provides data that will inform the prognosis for postoperative colic cases and identifies epiploic foramen entrapment as carrying a worse prognosis for survival than other strangulating lesions.  相似文献   

14.
Objective: To describe a novel surgical technique for management of right dorsal colitis in the horse. Study Design: Clinical report. Animals: 14‐year‐old Warmblood gelding. Methods: The horse was referred for treatment of a stromal abscess and signs of right dorsal colitis. Plasma chemistry revealed marked hypoproteinemia. Abdominal ultrasonographic examination showed a thickened right dorsal colon (RDC). Medical treatment was unsuccessful. With the horse in left lateral recumbency under general anesthesia, an approach to the right side of the abdomen through a 16th rib resection was made. The thoracic cavity was entered during the approach. Surgical resection of the RDC and side‐to‐side anastomosis of the diaphragmatic flexure to the small colon (bypass) was performed. The thoracic cavity was closed by attaching the diaphragm to the body wall and air was removed at the completion of surgery. Results: Resection of the RDC and bypass of the resected area was successfully performed. The colic signs and hypoproteinemia resolved. Complications of surgery included a deep surgical site infection with development of a large intrathoracic abscess. The abscess was managed with drainage and long‐term antimicrobial treatment. Conclusion: Right dorsal colitis can be treated successfully with resection and bypass of the RDC. In cases where the thoracic cavity is penetrated during the abdominal approach, the diaphragm should be sutured to the body wall at the beginning of surgery to avoid development of an infection within the thoracic cavity. Clinical Relevance: RDC resection and bypass may be an alternative approach for management of horses with right dorsal colitis.  相似文献   

15.
Ten horses were euthanatized before, during, or after surgery to correct severe volvulus of the large colon. At surgery, the colonic serosa changed from blue-gray, blue or purple toward a more normal pink in seven horses after the volvulus was corrected. The mucosa consistently remained black or dark red. Results of postmortem colonic microangiography revealed perfusion of the serosa and the circular and longitudinal muscle layers, but mucosal perfusion was limited by thrombosis in the muscularis mucosae and submucosa. There was evidence of thrombosis of the mesenteric colic vessels in six horses. Damage to the colonic vascular system, especially thromboembolism in the submucosa, may be an important limitation to colonic viability after surgical correction of volvulus of the large colon.  相似文献   

16.
Reason for performing study: It is a clinical impression that horses diagnosed with a right dorsal displacement (RDD) of the large colon, are more likely to suffer from recurrent episodes of colic post operatively, compared to other forms of nonstrangulating large colon displacement. Objectives: To investigate whether the type of nonstrangulating large colon displacement identified at exploratory laparotomy would influence long‐term outcome. Hypothesis: Horses identified with a RDD of the large colon at exploratory laparotomy would be more likely to experience recurrent episodes of post operative colic than other types of displacement. Materials and methods: Medical records for horses undergoing an exploratory laparotomy, from 2000–2008, for a nonstrangulating large colon displacement were reviewed. Data retrieved included: subject details, previous medical history, details of current episodes of colic, results of preoperative examination, surgical findings and procedures, post operative management and complications. Follow‐up information was obtained by reference to computerised clinical records and by telephone questionnaire administered to the horse's owner or carer, and included details of any colic episodes exhibited by the horse after discharge and whether a repeat celiotomy had been required to resolve the colic episodes. Results: There were 165 surgeries identified, in 154 horses. It was found that those horses with RDD were significantly more likely to experience recurrent episodes of colic requiring veterinary intervention post operatively compared to other types of displacement. Clinical relevance: Long‐term prognosis and likelihood of post operative complications is an important consideration for both owners and veterinarians.  相似文献   

17.
Studies in horses with experimental gastrointestinal fistulas may lead to rapid advancements in equine nutrition, as well as prevention and treatment of diseases such as colic and laminitis. The aim of this study was to devise a technique and a cannula to create a large fistula in the right dorsal colon (RDC). A total of 13 horses with normal gastrointestinal tract were used. After the administration of sedatives and local anesthetics, a segment of the right 16th rib was removed, a circular defect was created in the muscular wall, and the RDC was sutured to the muscular wall. The subcutaneous tissue and skin were closed over the attached RDC in eight horses (closed technique), or removed to expose the serosa of the colon sutured to the abdominal wall in five horses (open technique). A full thickness circular incision was made 2 to 6 weeks later to create a fistula. A cannula (diameter, 5 cm) made of natural rubber or silicon was inserted in the fistula. The open surgical technique was easier to perform and resulted in fewer complications. The cannula made of silicon resulted in less pruritus. One horse had a large colon torsion around the colopexy before fistula creation. One of the 12 fistulated horses had a large colon displacement 43 days after cannula insertion. These observations suggest that pexis of the RDC may predispose the horse to large colon displacement or volvulus. The open technique for the colopexy and the cannula made of silicon can be used for creation of a RDC fistula.  相似文献   

18.
Objective: To report a technique for semiclosed 1‐layer side‐to‐side jejunocecal anastomosis in horses. Study Design: Experimental study and clinical reports. Sample Population: Part 1—In vitro: Intestinal specimens from 24 horses collected immediately after death at an abattoir. Part 2—Clinical cases: 10 horses with clinical signs of colic requiring jejunocecostomy. Methods: Mean time to perform twelve 2‐layer handsewn (HS2L) and 12 semiclosed 1‐layer modified handsewn (SC) jejunocecal anastomoses was compared. Mean bursting pressures of anastomoses measured with a modified tank inflation test were compared. The SC technique was used in 10 horses that required jejunocecal anastomosis with and without resection (complete or incomplete ileocecal bypass). Results: The SC technique was significantly quicker to perform than HS2L technique. Clinically, the technique appeared safe with a major complication, associated with obstruction from kinking of the anastomosis, occurring in 1 horse. Conclusions: The SC technique was easy to perform with very little mucosal exposure in comparison to the HS2L technique, and was safe and effective in restoring intestinal continuity in clinical cases. Clinical Relevance: The SC technique should be considered for jejunocecostomy in horses because it reduces anastomosis time and mucosal exposure compared with other techniques.  相似文献   

19.
Colonic luminal pressure (median, range) measured during ventral midline celiotomy in 69 horses with strangulating obstruction (SO) of the large colon (SO; ≥ 270° large colon volvulus; 27 cm H2O: 2 to 80 cm H2O) was greater ( P =.0023) than that measured in 37 horses with nonstrangulating obstruction (NSO) of the large colon (NSO; ≤ 180° volvulus or a nonstrangulating displacement; 18 cm H2O; 6 to 46 cm H2O). Sixty-five percent (45 of 69) of horses with SO and all horses with NSO survived. Survival analysis was restricted to 59 horses with large-colon SO that survived to hospital discharge or met the criteria specified for classification as nonsurvivors. Colonic luminal pressure in nonsurvivors (48.5 cm H2O; 34 to 80 cm H2O) was higher ( P =.0001) than that measured in survivors (18 cm H2O; 2 to 50 cm H2O) of SO. From response operating characteristic curves, a luminal pressure of 38 cm H2O optimized the distribution of horses with SO into survivor and nonsurvivor groups. Sensitivity, specificity, and positive and negative predictive values for a colonic luminal pressure greater than 38 cm H2O in predicting nonsurvival were 0.89, 0.91, 0.72 and 0.97, respectively. Measurement of colonic luminal pressure may be useful for predicting survival in horses with colonic volvulus.  相似文献   

20.
Visualization of colonic mesenteric vasculature during transabdominal ultrasonographic examination of horses with colic can be a predictor of right dorsal displacement of the large colon or 180° large colon volvulus, or both. Medical records of 82 horses having had surgical treatment of colic and having received a transabdominal ultrasonographic examination on admission were reviewed. Colonic mesenteric vessels were sonographically identified coursing laterally on the right side of the abdomen in 24 of the 82 cases. Horses with colonic vessels identified on ultrasound were 32.5 times more likely to be diagnosed at surgery with either large colon right dorsal displacement or 180° large colon volvulus than those in which vessels were not seen (P < 0.001). Visualization of colonic mesenteric vessels on ultrasound provided a sensitivity of 67.7%, specificity of 97.9%, positive predictive value of 95.8%, and negative predictive value of 81% for large colon right dorsal displacement or 180° large colon volvulus, or both.  相似文献   

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