Elective inversion of the distal ileal stump into the caecum of the horse.

The distal 30 to 40 cm of the ileum cannot be exteriorized through a midline laparotomy incision because of its close anatomical association with the base of the caecum. A method was developed to deal with those cases where this segment of small intestine was involved in an avascular, necrotic process and therefore required resection. The technique involves inverting the distal stump of ileum into the lumen of the caecum and then performing a routine ileocaecal or jejunocaecal anastomosis. This avoids the risk of peritonitis if a Parker-Kerr oversew of the necrotic ileal stump should dehisce. The technique was performed on five clinically normal horses and on four horses in which the terminal 30 to 40 cm of the ileum was necrotic. The postoperative clinical findings and autopsy results of these horses are discussed.