Hepaticojejunostomy for treatment of common hepatic duct obstructions associated with duodenal stenosis in two foals

Cholangiectasis and Duodenal Diverticulosis in a Farm-Raised Elk (Cervus Elaphus)

A 6-year-old male elk presented in August with a 4-month history of weight loss and a 1-day history of being recumbent and unable to rise. The elk's body condition score was 1.5/5. Hematology and blood chemistry showed an inflammatory leukogram, mild electrolyte abnormalities, and elevated liver enzyme activities. Because of poor prognosis, the owner elected euthanasia. On necropsy, 8 diverticula were in the duodenum distal to the common bile duct, which was dilated and filled with feed material. Many intrahepatic bile ducts were dilated up to 5 cm, were filled with ingesta and gritty material, and had walls thickened up to 1.5 mm. On histologic examination, mural thickening of dilated bile ducts was because of increased fibrous connective tissue with inflammatory cell infiltration and hyperplastic and hypertrophic epithelial lining. Portal tracts diffusely contained hyperplastic bile ducts and had increased amounts of fibrous connective tissue. Abscesses that contained bacteria were scattered throughout the liver. Duodenal diverticula lacked the tunica muscularis, and the muscularis mucosa was hypertrophied. Caudal to some diverticula, the duodenal lumen was narrowed. An additional finding was embolic pneumonia with fungi morphologically and immunohistochemically consistent with Aspergillus spp.

Acute necrotising pancreatitis following grain overload in a donkey

A donkey developed abdominal discomfort and distension together with cardiovascular collapse and gastric reflux 24 to 36 hours after ingesting a large amount of poultry feed. Rectal findings prompted a laparotomy that identified extensive gastric dilation, an empty, atonic small intestine, dry colonic content and an easily corrected caecal displacement. These findings were not consistent with the severity of the signs, which were attributed to endotoxaemia. The donkey was euthanased during recovery. Necropsy revealed acute necrotising pancreatitis with massive gastric dilation and right dorsal colon impaction. The clinicopathological features of acute equine pancreatitis associated with grain overload are discussed.

Abdominal surgery in foals

Foals are good candidates for abdominal surgery because their smaller size permits a more complete abdominal exploration and frequently definitive procedures in many cases. The use of rectal examination is replaced with alternative diagnostic modalities such as barium contrast radiography and ultrasonography. With the advancements in these technologies they can distinguish common gastrointestinal lesions and, in most cases, provide sufficient information to guide surgical intervention. The unique aspects of diagnosis and surgical management of gastrointestinal disorders of the foal are discussed.

Instrumentation and techniques in equine gastrointestinal surgery

Recent advances in abdominal surgical techniques in the horse have resulted in improved survival rates and reduced postoperative morbidity. The development of abdominal surgical procedures in horses has paralleled the development of safe anesthetic protocols and innovative technological advancements in humans. Irrespective of the species, the application of sound surgical principles is still the foundation of surgical intervention. This article describes recent advances in equine gastrointestinal surgical techniques. The availability and application of innovative intestinal surgical devices and their specific uses in equine gastrointestinal surgery are also described.