Right dorsal colon resection and bypass for treatment of right dorsal colitis in a horse.
Authors: Lane Jennifer K, Cohen Jennifer M, Zedler Steven T, Hollis Anna R, Southwood Louise L
Journal: Veterinary surgery : VS
Summary
# Right Dorsal Colon Resection and Bypass for Chronic Colitis Right dorsal colitis represents a challenging condition in equine practice, particularly when medical management fails to resolve clinical signs and associated complications such as protein loss. This case report describes a novel surgical technique involving resection of the affected right dorsal colon with side-to-side anastomosis (bypass) between the diaphragmatic flexure and small colon, performed on a 14-year-old Warmblood gelding with stromal abscess and marked hypoproteinaemia. The surgical approach required a 16th rib resection, which necessitated entry into the thoracic cavity; the authors managed this complication by suturing the diaphragm to the body wall intraoperatively to prevent secondary infection. Post-operative colic signs and hypoproteinaemia resolved, demonstrating the potential efficacy of this resective approach, although the horse did develop a significant intrathoracic abscess requiring prolonged drainage and antimicrobial therapy. For practitioners managing horses with refractory right dorsal colitis, this technique warrants consideration as a salvage procedure, particularly when medical protocols have been exhausted; however, the substantial surgical morbidity and perioperative complications highlight the importance of careful case selection and owner counselling regarding the complexity of management.
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Practical Takeaways
- •RDC resection and bypass is a viable surgical option when medical management fails in right dorsal colitis cases, though complications can be severe
- •If thoracic cavity is breached during abdominal surgery, immediately suture the diaphragm to body wall to prevent postoperative intrathoracic infection
- •Expect prolonged recovery and potential serious complications—this is a high-risk salvage procedure requiring intensive postoperative monitoring and antimicrobial support
Key Findings
- •Right dorsal colon resection with bypass anastomosis to small colon successfully resolved colic signs and hypoproteinemia in a 14-year-old Warmblood gelding with refractory right dorsal colitis
- •Thoracic cavity penetration during 16th rib resection approach resulted in serious postoperative intrathoracic abscess requiring drainage and long-term antimicrobial therapy
- •Diaphragm suturing to body wall at surgical outset is recommended to prevent intrathoracic infection when thoracic cavity is entered during abdominal approach