Combination of end-to-end jejuno-ileal anastomosis and side-to-side incomplete ileocecal bypass (hybrid jejuno-ileo-cecal anastomosis) following subtotal ileal resection in seven horses

CASE DESCRIPTION 7 horses (3 geldings, 2 mares, and 2 stallions) were examined because of acute colic caused by small intestinal obstruction involving the aborad portion of the jejunum and orad portion of the ileum. CLINICAL FINDINGS All horses underwent a routine colic examination on arrival and had a diagnosis of strangulating obstruction of the small intestine. TREATMENT AND OUTCOME All horses underwent emergency exploratory laparotomy, in which the affected aborad portion of the jejunum and orad portion of the ileum were resected; in 5 horses, a hand-sewn end-to-end jejuno-ileal anastomosis was combined with a hand-sewn incomplete ileocecal bypass to produce a hybrid jejuno-ileo-cecal anastomosis. In 2 horses, the hand-sewn end-to-end jejuno-ileal anastomosis was combined with a half-stapled, half-hand-sewn incomplete ileocecal bypass. The procedures restored continuity of the small intestine with partial bypass of the ileocecal valve. All horses survived to hospital discharge, and none developed colic or ileus during the postoperative period. Follow-up revealed that 6 horses were living and had no subsequent signs of colic (4 to 17 months after surgery), and 1 was euthanized because of colic 17 months after surgery.

Automated summary

7 horses underwent emergency exploratory laparotomy for acute colic caused by small intestinal obstruction, with all horses surviving to hospital discharge and most showing no subsequent signs of colic.