Postoperative complications and survival after enterolith removal from the ascending or descending colon in horses.
Authors: Pierce Rebecca L, Fischer Andrew T, Rohrbach Barton W, Klohnen Andreas
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Enterolith Removal Surgery in Horses Enterolithiasis remains a significant surgical emergency in equine practice, yet uncertainty persists regarding whether the location of colonic obstruction influences surgical outcomes and recovery. Pierce and colleagues reviewed 236 cases of enterolith removal (97 ascending colon, 139 descending colon) between 1999–2005, tracking short-term complications until hospital discharge and long-term outcomes via follow-up at one year or beyond. Whilst descending colon cases showed higher rates of intraoperative euthanasia and greater incidence of postoperative anorexia and fever, these differences did not translate into disparate survival rates amongst horses discharged from hospital or assessed at 12+ months post-surgery; overall complication rates were similar regardless of obstruction site, with incisional problems, gastric ulceration and ileus dominating the immediate recovery period, and laminitis and weight loss emerging as common longer-term challenges. The findings suggest that enterolith location itself does not fundamentally alter prognosis, offering clinicians reassurance that horses obstructed in either the ascending or descending colon can be counselled towards a favourable long-term outlook provided they survive to discharge—though vigilance regarding postoperative complications, particularly gastrointestinal and incisional issues, remains essential for optimising recovery.
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Practical Takeaways
- •Owners can be counseled that location of enterolith (ascending vs descending colon) does not significantly impact long-term survival or complication rates post-operatively
- •Post-discharge monitoring should focus on incisional healing, laminitis prevention, nutritional support for weight maintenance, and recognition of recurrent colic signs
- •Short-term hospitalization complications like gastric ulceration and ileus are common post-enterolith surgery regardless of location; management protocols should account for these predictable issues
Key Findings
- •No significant difference in total postoperative complications between ascending (n=97) and descending (n=139) colon enterolith cases (P=0.76)
- •Descending colon enteroliths had higher incidence of anorexia (P=0.04) and fever (P=0.01) but similar long-term survival rates (P=0.47 at ≥1 year)
- •Most common short-term complications were incisional problems, gastric ulceration, ileus, diarrhea, fever, and anorexia
- •Most common post-discharge complications were incisional problems, laminitis, weight loss, and recurrent colic; horses had favorable long-term prognosis regardless of enterolith location