Laparoscopic Evaluation of the Epiploic Foramen after Celiotomy for Epiploic Foramen Entrapment in the Horse.
Authors: van Bergen Thomas, Wiemer Peter, Schauvliege Stijn, Paulussen Ellen, Ugahary Franz, Martens Ann
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Post-Surgical Assessment of Epiploic Foramen Closure Epiploic foramen entrapment remains a serious cause of acute colic in horses, yet recurrence rates following surgical treatment are surprisingly low—a phenomenon that deserves investigation. Van Bergen and colleagues used postoperative laparoscopy to examine whether spontaneous closure of the epiploic foramen occurs naturally after celiotomy, studying seven horses between 35 and 71 days following surgical correction. Remarkably, three of the seven horses (43%) demonstrated complete fibrotic obliteration of the foramen by the time of evaluation, whilst the remaining four animals underwent laparoscopic mesh closure (FEMC) without complications; importantly, all three horses that subsequently experienced recurrent colic episodes were confirmed cribbers or windsuckers. This work provides direct anatomical evidence that naturally occurring foramen closure does occur in a substantial proportion of cases, which may mechanistically explain the low clinical recurrence rates reported in larger retrospective studies. For practitioners, these findings suggest that aggressive preventive strategies to physically occlude the epiploic foramen may benefit horses with stereotypic behaviours, as the combination of these vices with an open foramen appears associated with recolicky episodes, and merit consideration during primary surgical management or at a planned second procedure.
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Practical Takeaways
- •About 40% of horses naturally close the epiploic foramen after surgical treatment without additional intervention, but be prepared for potential recurrence if closure does not occur
- •Horses with post-surgical colic and wind-sucking/cribbing behavior warrant close monitoring and possible preventive mesh closure consideration
- •Laparoscopic evaluation 5-10 weeks post-celiotomy can identify those horses requiring prophylactic mesh closure to prevent re-entrapment
Key Findings
- •3 of 7 horses (43%) demonstrated spontaneous closure of the epiploic foramen by dense fibrous tissue within 35-71 days after surgical treatment
- •4 horses required laparoscopic mesh closure (FEMC) to obliterate the epiploic foramen without major complications
- •3 horses experienced postoperative colic episodes, all displaying windsucking/cribbing behavior
- •Spontaneous foramen closure may explain the low recurrence rates previously reported in epiploic foramen entrapment cases