Right dorsal colon resection and bypass for treatment of right dorsal colitis in a horse.

OBJECTIVE: To describe a novel surgical technique for management of right dorsal colitis in the horse. STUDY
DESIGN: Clinical report. ANIMALS: 14-year-old Warmblood gelding.
METHODS: The horse was referred for treatment of a stromal abscess and signs of right dorsal colitis. Plasma chemistry revealed marked hypoproteinemia. Abdominal ultrasonographic examination showed a thickened right dorsal colon (RDC). Medical treatment was unsuccessful. With the horse in left lateral recumbency under general anesthesia, an approach to the right side of the abdomen through a 16th rib resection was made. The thoracic cavity was entered during the approach. Surgical resection of the RDC and side-to-side anastomosis of the diaphragmatic flexure to the small colon (bypass) was performed. The thoracic cavity was closed by attaching the diaphragm to the body wall and air was removed at the completion of surgery.
RESULTS: Resection of the RDC and bypass of the resected area was successfully performed. The colic signs and hypoproteinemia resolved. Complications of surgery included a deep surgical site infection with development of a large intrathoracic abscess. The abscess was managed with drainage and long-term antimicrobial treatment.
CONCLUSION: Right dorsal colitis can be treated successfully with resection and bypass of the RDC. In cases where the thoracic cavity is penetrated during the abdominal approach, the diaphragm should be sutured to the body wall at the beginning of surgery to avoid development of an infection within the thoracic cavity. CLINICAL RELEVANCE: RDC resection and bypass may be an alternative approach for management of horses with right dorsal colitis. © Copyright 2010 by The American College of Veterinary Surgeons.