title: Strangulating obstruction caused by intestinal herniation through the proximal aspect of the cecocolic fold in 9 horses.
abstract: OBJECTIVE
  To report the clinical and surgical findings and outcome for horses with strangulating obstruction caused by herniation through the proximal aspect of the cecocolic fold.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Nine horses.
  
  
  METHODS
  Medical records were reviewed for clinical signs, surgical findings and technique, and outcome. Cadaver ponies and necropsy specimens were also used to study the regional anatomy of the cecocolic fold.
  
  
  RESULTS
  The ileum and distal jejunum were strangulated in 8 horses, whereas in 1 horse the small intestine and the left ascending colons were incarcerated in a rent in the cecocolic fold. Two horses were euthanatized at surgery, 6 horses had a small intestinal resection (mean length, 3 m; range, 1.5-6.4 m) and an end-to-side jejunocecostomy, and the entrapment was reduced without resection in the horse that had small intestine and ascending colon incarceration; cecocolic fold defects were not closed. One horse was euthanatized 36 hours after surgery because of endotoxemia. Six horses were discharged; 4 were available for long-term follow-up, of which 2 were euthanatized, and 2 were euthanatized 12 and 18 months after surgery because of colic signs. Variations in thickness of the cecocolic fold were observed in specimens obtained from necropsy of other horses and ponies.
  
  
  CONCLUSIONS
  Reasons for this defect are unknown, although observed anatomic differences in cecocolic fold thickness may contribute to the development of defects.
  
  
  CONCLUSIONS
  Reduction of the entrapped bowel is easiest when traction is placed on the bowel at a 90 degrees to the base of the cecum. Intestinal incarceration through rents within the proximal part of the cecocolic fold should be considered as a differential diagnosis for strangulating obstruction in horses.
authors.affiliation: Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh 27606, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Gayle
authors.forename: M A
authors.initials: MA
authors.lastname: Macharg
authors.forename: J E
authors.initials: JE
authors.lastname: Smallwood
mesh_terms: D000818:Animals; D002429:Cecal Diseases / Q000601:surgery / Q000662:veterinary*; D005260:Female; D006547:Hernia / Q000150:complications / Q000662:veterinary; D059685:Herniorrhaphy; D006734:Horse Diseases / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006736:Horses; D007077:Ileal Diseases / Q000601:surgery / Q000662:veterinary*; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery / Q000662:veterinary*; D007579:Jejunal Diseases / Q000601:surgery / Q000662:veterinary*; D008297:Male; D011996:Records / Q000662:veterinary; D012189:Retrospective Studies; D016896:Treatment Outcome