Cecal amputation within the right ventral colon for surgical treatment of nonreducible cecocolic intussusception in 8 horses.
Authors: Hubert J D, Hardy J, Holcombe S J, Moore R M
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Cecal Amputation for Cecocolic Intussusception Cecocolic intussusception—where the cecum invaginates into the right ventral colon—represents a particularly challenging colic presentation, especially when manual reduction proves impossible during exploratory surgery. This retrospective review examines outcomes in eight horses treated via partial cecal amputation through a ventral colotomy approach, a technique that avoids the need for successful reduction and instead removes the affected tissue. All eight horses survived to discharge with median hospitalisation of 12 days, and seven of eight had long-term survival (median 30 months) with return to previous or improved function, despite colic duration ranging from 6 hours to 6 months and surgical times of approximately three hours. The procedure involved establishing a colotomy over the intussusceptum site, manually drawing invaginated cecal tissue into the right ventral colon, ligating or suturing the base, and amputating the affected portion before closing with a double-inverting pattern. For practitioners, this evidence supports a definitive surgical approach when intraoperative reduction fails: rather than prolonging anaesthesia with repeated reduction attempts, amputation offers a straightforward alternative with excellent short and long-term outcomes, even in cases with extended colic duration prior to surgery.
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Practical Takeaways
- •Cecal amputation via right ventral colotomy is a viable surgical option for nonreducible cecocolic intussusception with good long-term prognosis, as 7/8 horses returned to function despite the invasive nature of the procedure
- •Expect surgical time around 3 hours and hospitalization around 2 weeks; manual reduction attempts are likely to fail and amputation will be necessary
- •Post-operative prognosis is favorable even with surgical site contamination; continued antibiotic support (median 7 days) supports good outcomes
Key Findings
- •All 8 horses survived to hospital discharge following cecal amputation through right ventral colotomy for nonreducible cecocolic intussusception
- •7 of 8 horses survived long-term (median 30 months, range 6–96 months) and returned to or exceeded previous function
- •Median surgical time was 180 minutes with median hospitalization of 12 days and 7 days antibiotic therapy
- •Manual reduction of intussusception was unsuccessful in most cases, requiring invaginated cecum to be pulled into right ventral colon and amputated