Surgical correction of nephrosplenic entrapment of the large colon in 3 horses via standing left flank laparotomy.
Authors: Krueger Clarisa R, Klohnen Andreas
Journal: Veterinary surgery : VS
Summary
# Nephrosplenic Entrapment: A Standing Surgical Alternative Nephrosplenic entrapment of the large colon is a challenging form of colic that often fails to respond to medical management alone, yet traditional surgical correction requires general anesthesia and its associated risks and costs. Krueger and Klohnen presented a case series of three horses treated via standing left flank laparotomy under sedation and local analgesia, using a modified grid approach to directly visualise and manually correct the entrapment. All three horses had their entrapment successfully resolved, with only one developing postoperative fever; notably, all were discharged within 48–72 hours and returned to their previous level of work within 30 days. For practitioners managing horses where medical therapy (including phenylephrine and jogging) has failed and recumbent surgery is contraindicated—whether due to financial limitations, patient age, or anaesthetic risk—standing flank laparotomy offers a viable alternative that significantly reduces hospitalisation time and costs whilst maintaining excellent functional outcomes. This technique warrants consideration in any equine practice with access to appropriate facilities and expertise, particularly when conventional approaches are unavailable or unsuitable.
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Practical Takeaways
- •Standing flank laparotomy is a practical surgical option for nephrosplenic entrapment in horses that fail to respond to medical therapy (phenylephrine, jogging) and cannot undergo general anesthesia due to cost or risk
- •This technique enables rapid return to work (within 30 days) and significantly reduces hospitalization time and costs compared to exploratory celiotomy under general anesthesia
- •Diagnosis should be confirmed via rectal palpation and transabdominal ultrasonography before pursuing surgical intervention
Key Findings
- •Standing left flank laparotomy successfully corrected nephrosplenic entrapment in all 3 horses (100% success rate)
- •Horses were discharged within 48-72 hours and returned to previous use within 30 days
- •Only 1 of 3 horses developed postoperative fever, with no other major complications reported
- •Standing surgical approach offers viable alternative for horses unresponsive to medical management when general anesthesia is contraindicated