title: Hand-assisted laparoscopic repair of a grade IV rectal tear in a postparturient mare.
abstract: METHODS
  An 8-year-old multiparous Thoroughbred broodmare was admitted for evaluation of a rectal tear sustained during parturition.
  
  
  RESULTS
  On initial evaluation, the mare had mild signs of abdominal discomfort. A full-thickness rectal tear located 30 cm cranial to the anus and extending approximately 15 cm longitudinally along the surface of the small colon between the 4 and 6 o'clock positions, when viewed from behind, was diagnosed on examination per rectum.
  
  
  RESULTS
  Laparoscopic evaluation of the abdomen was performed to assess the tear and extent of peritoneal contamination. A hand-assisted repair via a flank incision was performed. The tear was closed in a single-layer, simple continuous pattern with size-0 polydioxanone with a handheld needle holder. Subsequently, a ventral midline celiotomy was performed, and intestinal contents were evacuated via a pelvic flexure enterotomy and a typhlotomy. Following surgery, the mare was managed with IV fluid therapy, partial parenteral nutrition, antimicrobials, and NSAIDs for 5 to 7 days before being gradually reintroduced to a complete pelleted feed and alfalfa hay. Prior to discharge, examination per rectum revealed no stricture formation associated with repair. The mare was discharged from the hospital and performed successfully as a broodmare, with the delivery of a live foal 1 year after surgery.
  
  
  CONCLUSIONS
  Successful repair with an excellent outcome was achieved in this mare. Hand-assisted laparoscopic repair should be considered as a possible treatment option in horses with grade IV rectal tears.
authors.affiliation: Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA 19348.
authors.forename: Suzanne G
authors.initials: SG
authors.lastname: Stewart
authors.forename: Janet K
authors.initials: JK
authors.lastname: Johnston
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Parente
mesh_terms: D000818:Animals; D005260:Female; D058733:Hand-Assisted Laparoscopy / Q000662:veterinary*; D006734:Horse Diseases / Q000601:surgery*; D006736:Horses; D007744:Obstetric Labor Complications / Q000601:surgery / Q000662:veterinary*; D011247:Pregnancy; D012007:Rectum / Q000293:injuries*; D014947:Wounds and Injuries / Q000601:surgery / Q000662:veterinary*