Laparoscopic Evaluation of the Epiploic Foramen after Celiotomy for Epiploic Foramen Entrapment in the Horse

ObjectivesTo evaluate the epiploic foramen using laparoscopy in horses previously treated for epiploic foramen entrapment to determine if spontaneous epiploic foramen closure had occurred. Study DesignNon-consecutive case series. AnimalsSeven horses. MethodsThe epiploic foramen was inspected by right flank laparoscopy between 35 and 71 days after successful surgical treatment for epiploic foramen entrapment. Data were collected on the presence of behavior vices, details of surgery for epiploic foramen entrapment (time from colic onset to surgery, site and length of entrapped intestine, direction of entrapment, compromise of the intestine, intestine resected), the time between surgery for epiploic foramen entrapment and laparoscopy, and the laparoscopic appearance of the epiploic foramen. If the epiploic foramen was open, a mesh was introduced to obliterate the epiploic foramen (Foramen Epiploicum Mesh Closure [FEMC]). Clinical progress of the horses was followed by owner telephone interview at 1 and 4 months after laparoscopy, and a final interview between 135 and 282 days after laparoscopy. Owners were questioned on specific postoperative complications and the exercise level of the horse. ResultsAt laparoscopy, 3/7 horses had complete closure of the epiploic foramen by dense fibrous tissue. The FEMC was performed in 4 horses without major complications. Postoperative colic episodes were recorded in 3 horses, all of them displaying windsucking/cribbing behavior. ConclusionLaparoscopic evaluation after celiotomy for epiploic foramen entrapment revealed spontaneous closure of the epiploic foramen in 3/7 horses. This finding could explain the reported low recurrence rate after surgical treatment for epiploic foramen entrapment.