Equine colic associated with small intestinal epiploic foramen entrapment.
Authors: van Bergen Thomas, Wiemer Peter, Martens Ann
Journal: Veterinary journal (London, England : 1997)
Summary
# Editorial Summary Epiploic foramen entrapment (EFE) remains a serious surgical colic presentation with historically poor outcomes, yet emerging evidence suggests prognosis may be considerably better than previously reported when appropriate techniques are applied. The ileum is affected in most cases, with crib-biting and windsucking identified as significant risk factors, though surprisingly the recurrence rate is low—possibly because spontaneous closure of the foramen occurs in approximately 40% of cases following surgical intervention. Van Bergen and colleagues synthesise current knowledge on both medical management and preventive surgical approaches, including minimally invasive laparoscopic techniques for foramen obliteration in at-risk horses and during exploratory laparotomy. Their analysis highlights how improved anatomical understanding of the region, refined anastomosis techniques, and post-operative reflux prevention substantially influence survival and return to function. For practitioners, this work supports considering EFE obliteration in horses with risk factors or recurrent colic, and emphasises that aggressive intraoperative decision-making based purely on prognostic pessimism may no longer be justified given contemporary surgical refinements.
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Practical Takeaways
- •Consider EFE as a differential diagnosis in colic cases, particularly in horses with crib-biting/windsucking behavior; outcomes have historically been poor with high euthanasia rates during surgery
- •Know that many horses may recover without intervention through spontaneous epiploic foramen closure (~40%), but preventive laparoscopic obliteration is an option for high-risk individuals
- •Improved surgical success depends on anatomical understanding of the region, careful anastomosis technique selection, and prevention of post-operative reflux complications
Key Findings
- •Ileum is involved in the majority of epiploic foramen entrapment cases in horses
- •Crib-biting and windsucking are the most important risk factors for developing EFE
- •Spontaneous closure of the epiploic foramen occurs in approximately 40% of cases after EFE colic surgery
- •Laparoscopic techniques can safely obliterate the epiploic foramen preventively in at-risk horses or during surgical management