Gandini, Marco

Giusto, Gessica

English

Institutional Research Information System University of Turin

92NEW DEVICE FOR ELECTIVE INVERSION OF THENECROTIC ILEAL STUMPGandini M. and Giusto G.Department of Veterinary Sciences, University of Turin, L.goPaolo Braccini 2-5, Grugliasco (TO), Italy.Email: marco.gandini@unito.itBackground: Leaving a necrotic ileal stump has beenblamed as a cause of poor prognosis in jejunocaecalanastomosis. Elective inversion of the necrotic stump hasbeen described by means of a nasogastric tube, althoughthis procedure can be cumbersome and has been reportedto cause caecocolic orifice occlusion.Objectives: To describe a new device and its use for electiveinversion of necrotic ileal stump.Methods: The device was constructed securing 0.5 m ofhemp tape to a 0.7 m of electrical cable puller. The device isinserted in the ileum and passed into the caecum. A TA90stapler or USP 2 PDS suture is used to occlude the ileal lumenand simultaneously secure the tape to the intestine. The ileumis then resected. A small tiphlotomy is made at the proposedsite for the jejunocaecal anastomosis. The device, protectedby an arthroscopy sleeve, is retrieved by an assistant. Thehemp tape is cut flush to the ileal mucosa. The tiphlotomy isclosed. The device was tested ex-vivo for pullout force with adigital dynamometer and used in three clinical cases.Results: The device was easily secured to the intestine. Smallenterotomies were sufficient both to insert and remove thedevice. Securing of the device to the intestine resultedeffective both with TA stapler and sutures.Conclusions: The device resulted effective in inverting theileal stump in clinical cases. Leaving a short, inverted stump,this method could help improving prognosis for jejunocaecalanastomosis, possibly avoiding undesired side effects of theprocedure.Ethical animal research: No ethical approval required.Source of funding: None.Competing interests: None.ReferencesEkert, R.S., Crowson, L.C., Moll, D., Bentz, B.G., Confer, A.W. and Blaik,M.A. (2003) Obstruction of the caecocolic orifice by ileocecocolicintussusception following jejunocecostomy in a horse. J. Am. Vet.Med. Ass. 12, 1743-1745.Vasey, J.R. and Julian, R.J. (1987) Elective inversion of thedistal ileal stump into the caecum of the horse. Equine Vet. J. 19,223-225.93VOLVULUS NODOSUS OF THE SMALL INTESTINE:DIFFERENCES IN FOALS AND ADULTS (5 CASES)Gandini M. and Giusto G.Department of Veterinary Sciences, University of Turin, L.goPaolo Braccini 2-5, Grugliasco (TO), Italy.Email: marco.gandini@unito.itBackground: Volvulus nodosus is a strangulating lesion of thesmall intestine described only in foals and in just one case inolder horses. Huskamp (1982) described the pathophysiologyof volvulus nodosus in foals, but to date there is nodescription of the pathophysiology of volvulus nodosus inadults.Objectives: To describe the different features of volvulusnodosus in adult horses and in foalsMethods: Analysis of the clinical and anatomical features oftwo foals and three adults presenting with volvulus nodosus.Results: Clinical presentation between foals and adultsdiffered mainly for the mild or absent pain showed by olderhorses. Clinical and ultrasonography findings were similar. Atsurgery or necropsy we found anatomical differencesbetween adults and foals. In adults, the volvulus didn’tinvolve the mesentery that instead forms a hernia sac in foals.Further, in adults, there wasn’t involvement of the ileum buttwo loops of jejunum resulted one wrapped around anotherin all three cases. After accurate analysis of one case atnecropsy, we found that in adults one loop act as a ‘post’around which another loop turns around. The weight of thisloop causes then the formation of a half-hitch formed by thetwo loops and their mesentery. This cause strangulation andnecrosis of two separate tract of jejunum.Conclusions: Volvulus nodosus may occur in adult horses withsignificant differences compared to foals. Knowing thepresentation and pathophysiology of volvulus nodosus mayhelp equine surgeons to resolve selected cases of smallintestinal strangulation in adult horses.Ethical animal research: Not required.Source of funding: None.Competing interests: None.ReferencesDorges, F., Vornberger, K. and Stadler, P. (1993) SonographischeDartstellung eines indolenten Volvulus nodosus bei einerKleinpferdstute. Pferdeheilkunde, 9, 369-372.Huskamp, B., Daniels, H. and Kopf, N. (1982) Magen- undDarmkrankheiten fur wissenschaft und Praxis. VEB Gustav FischerVerlag. Jena. 557-559.94WHY IS THE ILEUM INVOLVED IN THE MAJORITY OFCASES OF INTERNAL HERNIAS? A BIOMECHANICALHYPOTHESISGandini M. and Giusto G.Department of Veterinary Sciences, University of Turin, L.goPaolo Braccini 2-5, Grugliasco (TO), ItalyEmail: marco.gandini@unito.itBackground: Ileum is involved in 64–81% of cases of epiploicforamen entrapment and 49–53% of inguinal hernias. To dateno explanation for this occurrence has been proposed.Objectives: To offer a possible explanation of the high rate ofileal involvement in internal herniasMethods: Analysis of the surgical and anatomical features of21 cases of strangulation of the small intestine in internalhernia in horses.Results: In 6/13 cases involving the ileum, the incarceratedsegment presented less severe pathological featuresproceeding proximal to distal. These suggest a different,progressive involvement of the distal bowel along with theduration of the pathology. We hypothesised that the relativemovement between bowel and ingesta may cause this.Once a portion of intestine enters the hernial port, its luminalcontent cannot proceed aborally due to the external luminal© 2021 The Authors. Equine Veterinary Education © 2021 EVJ Ltd48 Abstracts

NEW DEVICE FOR ELECTIVE INVERSION OF THE NECROTIC ILEAL STUMP

https://iris.unito.it/bitstream/2318/1964511/1/Equine%20Veterinary%20Education%20-%202021%20-%20%20-%20NEW%20DEVICE%20FOR%20ELECTIVE%20INVERSION%20OF%20THE%20NECROTIC%20ILEAL%20STUMP.pdf

NEW DEVICE FOR ELECTIVE INVERSION OF THE NECROTIC ILEAL STUMP

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