Vorkommen und Bedeutung spontaner und postoperativer peritonealer Adhäsionen bei Pferden
Incidence and clinical significance of spontaneous and postoperative peritoneal adhesions in horses
Gerhards H
DOI: 10.21836/PEM19900604
Jahr: 1990
Volume: 6
Ausgabe: 6
Seiten: 277-288
The purpose of this study was to determine the incidence of spontaneous and postoperative peritoneal adhesions in the equine species. The clinical records of 855 horses evaluated for diseases of the digestive tract at the Clinic for Horses of the Hannover School of Veterinary Medicine, and related literature on equine colic surgery were reviewed. Case selection was restricted to horses which survived the initial laparotomy for more than 3 days and in which adhesions were responsible for postoperative abdominal pain as documented during necropsy or relaparotomy. Spontaneous adhesions occurred in 19 of 386 horses (4,9% incidence) and all of them were classified as inflammatory in origin. In 14 cases the adhesions had caused acute intestinal obstructions. The large intestine was involved in 8 horses, the small intestine was involved in 7 horses and small and large intestine were involved in 4 horses. 14 of the 19 horses had to be destroyed during surgery. Summarizing the results of the record review and of the literature review the overall incidence of spontaneous adhesions was 3,5 % (58 spontaneous adhesions among 1,641 explorative laparotomies). Figures on the incidence of clinically significant postoperative adhesions were different. The records of 85 horses which died oder had to be destroyed later than 3 days after a colic surgery were reviewed. 24 horses (28,2% incidence) had adhesions and all had produced signs of abdominal pain. 22 of these 24 horses died or had to be destroyed. No significant adhesions were found in horses which died postoperatively from other conditions than from intestinal obstructions (e.g. from laminitis). There were 26 small intestinal adhesions, the abdominal wall was involved in 7 cases, the cecum and the large colon were involved in 3 cases each. Most often the development of postoperative adhesions was associated with small intestinal impactions, hernias and small intestinal enterotomy and resection. 22 of the 24 horses had shown signs of abdominal discomfort within 6 weeks postoperatively. The results of the literature review and of the record review indicated an overall incidence of postoperative adhesions of.2 7 % (70 horses with adhesions out of 1,298 horses subjected to relaparotomy or necropsy) with a mortality rate of 78,6%.