A topographic anatomical study of the equine epiploic foramen and comparison with laparoscopic visualisation.
Authors: van Bergen T, Doom M, van den Broeck W, Wiemer P, Clegg P D, Cornillie P, Martens A
Journal: Equine veterinary journal
Summary
# Editorial Summary: Equine Epiploic Foramen Anatomy and Laparoscopic Visualisation The epiploic foramen—a critical anatomical gateway in equine abdominal surgery—has never been comprehensively mapped and correlated with laparoscopic findings, prompting van Bergen and colleagues to conduct a detailed anatomical study using 32 cadavers, polyurethane casts, histological examination and laparoscopic video review. Their work established that the hepatoduodenal ligament, hepatogastric ligament, and gastropancreatic and hepatopancreatic folds define the foramen, with a notable secondary fold forming the ventral border that contains a central elastin-rich connective tissue core; the hepatic artery runs partially within the hepatoduodenal ligament itself. Mean epiploic foramen circumference measured 11.6 ± 2.6 cm and scaled proportionally with body weight, independent of age or sex. Because all defining structures are clearly identifiable laparoscopically, this anatomical foundation should guide surgical decision-making for foramen-related conditions and supports development of novel interventions for pathologies affecting this region—knowledge particularly valuable for equine veterinary surgeons and those managing postoperative complications or planning elective abdominal procedures.
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Practical Takeaways
- •Understanding the precise anatomy of the epiploic foramen and its elastin-containing structures is essential for laparoscopic surgeons managing epiploic foramen-related colic, as these structures are clearly visualizable during standing right flank procedures.
- •Body weight should be considered when assessing epiploic foramen dimensions clinically, as circumference correlates positively with weight; age and gender do not affect foramen size.
- •Familiarity with the laparoscopic appearance of defining structures (ligaments and folds) helps surgeons develop targeted interventions for epiploic foramen entrapment and other related pathologies.
Key Findings
- •The epiploic foramen is defined by hepatoduodenal ligament, hepatogastric ligament, and gastropancreatic and hepatopancreatic folds, all clearly visible laparoscopically.
- •Mean circumference of epiploic foramen is 11.6 ± 2.6 cm and shows positive correlation with body weight but not with age or gender.
- •The hepatoduodenal ligament contains a secondary fold forming the ventral border, composed primarily of elastin fibres in its connective tissue core.
- •The hepatic artery is incorporated into the hepatoduodenal ligament for part of its course, representing a clinically relevant anatomical relationship.