Complications following transcutaneous cecal trocarization in horses with a cattle trocar and a cecal needle.
Authors: Dória Renata Gebara Sampaio, Reginato Gustavo Morandini, Hayasaka Yumi de Barcelos, Fantinato Neto Paulo, Passarelli Danielle, Arantes Julia de Assis
Journal: PloS one
Summary
# Editorial Summary: Cecal Trocarization Complications in Horses Percutaneous decompression of the cecum offers a potential emergency intervention for horses with gas distension, yet the safety profile of different instrumentation remains poorly characterised. Sampaio and colleagues conducted a controlled study in six mixed-breed horses, comparing transcutaneous cecal trocarization using either a cattle trocar or a specialised cecal needle against a non-intervention control group, with serial monitoring of clinical signs, blood parameters, and peritoneal fluid analysis over 14 days. Both trocarization methods induced measurable peritoneal inflammation—evidenced by increased nucleated cell counts, total proteins, globulins, and acute-phase proteins in peritoneal fluid—yet neither caused clinically relevant peritonitis (CRP) as defined by concurrent clinical deterioration such as fever, anorexia, or ileus beyond isolated fever episodes in three horses. The cattle trocar produced a more pronounced inflammatory response than the cecal needle, whilst both techniques resulted in temporary reduction in cecal motility without triggering systemic complications or requiring intervention. For practitioners managing acute cecal tympany, these findings support the use of needle trocarization as the lower-impact approach, reserving cattle trocars for situations where needle decompression proves inadequate, thereby minimising peritoneal trauma whilst maintaining the ability to rapidly relieve life-threatening gas distension.
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Practical Takeaways
- •Cecal trocarization can be performed safely in emergency situations for cecal tympany, but expect subclinical peritoneal inflammation lasting up to 14 days regardless of technique
- •Use a cecal needle rather than a cattle trocar if available, as it causes less peritoneal tissue damage and inflammatory response while achieving the same decompression
- •Monitor for fever and reduced appetite post-procedure as indicators of inflammation, but clinically relevant peritonitis is unlikely if horses maintain systemic stability
Key Findings
- •All horses recovered from cecal trocarization without major complications, though cytologic evidence of peritonitis was present in both groups over 14 days
- •Cattle trocar caused more intense peritoneal inflammation than cecal needle, with increased total nucleated cells, proteins, globulins, and acute phase proteins
- •Clinically relevant peritonitis did not develop in either group despite peritoneal changes, though three horses experienced transient fever episodes
- •Both procedures resulted in decreased cecal motility during the experimental period and reduced blood neutrophils at later timepoints