Idiopathic focal eosinophilic enteritis associated with small intestinal obstruction in 6 horses.
Authors: Southwood L L, Kawcak C E, Trotter G W, Stashak T S, Frisbie D D
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Idiopathic Focal Eosinophilic Enteritis in Horses Focal eosinophilic enteritis—inflammation of unknown origin localised to a discrete segment of small intestine—can cause acute colic and intestinal obstruction in horses, yet remains poorly characterised in the clinical literature. Southwood and colleagues retrospectively reviewed six cases presenting with persistent abdominal pain, small intestinal distension, and nasogastric reflux secondary to eosinophilic lesions; all were managed surgically through either full-thickness resection with anastomosis or partial wedge resection of the affected bowel segment. Remarkably, five of the six horses (83%) remained alive at follow-up ranging from 5 to 60 months post-operatively, with no evidence of disease recurrence or extension beyond the original lesion site. The favourable long-term prognosis suggests that aggressive surgical intervention—rather than conservative management—should be considered in horses presenting with colic refractory to medical treatment where nasogastric reflux and small intestinal obstruction indicate a focal lesion. Whilst the aetiology remains elusive, clinicians should maintain awareness that eosinophilic enteritis, though rare, represents a surgically correctable cause of acute equine colic.
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Practical Takeaways
- •When presented with acute colic showing persistent pain, small intestinal distension, and nasogastric reflux, consider idiopathic focal eosinophilic enteritis as a possible diagnosis requiring surgical exploration.
- •Surgical resection of the affected intestinal segment offers a favorable long-term prognosis with 83% survival rate in this case series, suggesting aggressive surgical intervention is warranted.
- •Post-operative complications from disease extension at the lesion site were not observed in these cases, supporting standard resection and anastomosis techniques without need for extended margins.
Key Findings
- •Six horses with idiopathic focal eosinophilic enteritis presented with persistent abdominal pain, small intestinal distension, and nasogastric reflux requiring surgical intervention.
- •Surgical treatment consisted of intestinal resection and anastomosis or wedge resection of the affected focal lesion.
- •Five of six horses (83%) survived to long-term follow-up at 5 to 60 months post-operatively with no observed complications from disease extension.
- •Focal eosinophilic enteritis lesions of unknown etiology should be considered as a differential diagnosis for acute small intestinal obstruction in horses.