title: Identification, management and outcome of postoperative hemoperitoneum in 23 horses after emergency exploratory celiotomy for gastrointestinal disease.
abstract: OBJECTIVE
  To investigate postoperative hemoperitoneum in a population of horses that had surgery for colic.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Horses (n = 23).
  
  
  METHODS
  Preoperative, intraoperative, and postoperative information was obtained from medical records (1985-2012) of horses with postoperative hemoperitoneum after emergency exploratory celiotomy. Pre-existing hemoperitoneum during surgery and nonsurgical hemoperitoneum were excluded.
  
  
  RESULTS
  Of 4520 horses that had emergency exploratory celiotomy for gastrointestinal disease, 23 horses met inclusion criteria; an incidence of 0.5%. Horse signalment approximated the colic population, although Thoroughbreds were significantly overrepresented. Hemoperitoneum was significantly associated with intestinal resection. Postoperative hemoperitoneum was recognized a mean (± SD) of 1.0 ± 0.7 days after surgery and associated with tachycardia, decreasing hematocrit, incisional drainage, or ultrasonographic identification of swirling, echogenic abdominal fluid. Primary treatments included intravenous fluid therapy (n = 23), colloid support (20), blood transfusion (13), and antifibrinolytic agents (11). Fifteen horses (65%) survived to discharge, which was associated with admission lactate and days of hospitalization.
  
  
  CONCLUSIONS
  Postoperative hemoperitoneum is a rare complication of exploratory celiotomy in horses that should be considered when there are signs of abdominal discomfort and declining hematocrit in the early postoperative period. Prognosis is guarded because of potential sequelae of septic peritonitis and adhesion formation.
authors.affiliation: William R Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, California.
authors.forename: Sarah N
authors.initials: SN
authors.lastname: Gray
authors.forename: Julie E
authors.initials: JE
authors.lastname: Dechant
authors.forename: Sarah S
authors.initials: SS
authors.lastname: LeJeune
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Nieto
mesh_terms: D000818:Animals; D003085:Colic / Q000601:surgery / Q000662:veterinary*; D004638:Emergency Treatment / Q000662:veterinary; D005260:Female; D005767:Gastrointestinal Diseases / Q000601:surgery / Q000662:veterinary*; D006465:Hemoperitoneum / Q000209:etiology / Q000628:therapy / Q000662:veterinary*; D006734:Horse Diseases / Q000601:surgery*; D006736:Horses; D010535:Laparoscopy / Q000009:adverse effects / Q000662:veterinary*; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000628:therapy / Q000662:veterinary*; D012189:Retrospective Studies