Small intestine incarceration through the epiploic foramen of the horse.

Fifteen horses were referred to Purdue University or to the University of Georgia because of colic. Each of these horses had small intestine incarcerated through the epiploic foramen. However, signs of pain, gastric reflux, and small intestine distention were not consistent signs, as would have been expected with small intestine strangulation/obstruction. In 10 of the 15 cases, abdominal fluid analysis provided the decisive information needed for surgical intervention. Surgery was performed in 14 cases. The small intestine was incarcerated through the epiploic foramen in a right-to-left direction in 12 cases and in a left-to-right direction in 3 cases. The intestinal incarceration was reduced by gentle traction on the adjacent unaffected intestine. Resection and anastomosis were performed in 10 cases. Twelve of the 14 surgical patients died, and it was believed that the failure to intervene surgically at an earlier time contributed to these poor results. Surgery was delayed in most cases because of the inconsistent clinical signs observed in these horses. It was concluded that small intestine incarceration through the epiploic foramen should be suspected in any case of colic that has inconsistent physical findings and does not resolve in short time. Further, serial abdominal fluid analysis should be used in such cases in order to detect changes or trends that would indicate a lesion requiring surgical intervention.