EQUINE VETERINARY EDUCATION Equine vet. Educ. (2020) 32 (8) 407 doi: 10.1111/eve.13035_1


Case Report


Colopexy dehiscence preceding an episode of large colon volvulus, followed by repeat colopexy, in three Thoroughbred broodmares


M. D. Hall* and D. H. Rodgerson


Hagyard Equine Medical Institute, Lexington, Kentucky, USA *Corresponding author email: mark.hall@ucdconnect.ie Keywords: horse; surgery; gastrointestinal tract; colopexy


Summary


Three Thoroughbred mares ranging in age from 5 to 9 years, that had undergone previous colopexy following surgical correction of a large colon volvulus, presented for colic signs unresponsive to medical management. Exploratory laparotomy was elected and a midline celiotomy was performed in the caudal aspect of the ventral abdomen in each mare, due to the fact that a colopexy had been performed previously. Examination of the cranial abdomen revealed the large colon was not adhered to the ventral body wall, indicating dehiscence of the previous colopexy. Further examination of the abdomen in each mare revealed a 360- degree large colon volvulus. The previous colopexy site appeared as a linear haemorrhagic area of fibrosis in one mare (Figs 1 and 2) and a pale area of fibrosis in two other mares. The large colon volvulus was corrected and a second colopexy was then performed at the same site and using the same technique as the first colopexy – by incorporating 10– 12 cm of the lateral free band of the left ventral colon into the midline linea alba closure using number 3 polyglactin 910 (Vicryl). In this technique, the colopexy is placed in the cranial 10–15 cm of the incision, at a site on the lateral free band of the left ventral colon at least 40 cm from the Caecocolic ligament. The remainder of the linea alba incision is closed using the same suture pattern but without incorporating the tenia from the colon. The skin is then closed in a routine fashion.


The time elapsed between the first and second colopexy


in each mare was 48, 1496 and 616 days. The mares each recovered uneventfully from anaesthesia and were discharged 2–10 days later. Two of the mares are still alive at the time of manuscript submission, 593 and 907 days post-operatively. The third mare survived 4 years post- operatively, following which she was lost to follow-up. Data available from our clinic indicate an incidence rate of 0.79% for colopexy dehiscence followed by a repeat episode of large colon volvulus. This phenomenon should be considered as a differential diagnosis when a mare that previously underwent a colopexy presents with severe signs of colic.


Key points • If a colopexy has been performed previously by incorporating the left ventral colon into the midline linea alba closure, any future midline celiotomy should be performed in the caudal aspect of the ventral abdomen.


• In each case, the second colopexy was performed in the same location on the lateral free band of the left ventral colon as the first colopexy.


• Colopexy dehiscence followed by large colon volvulus should be considered as a differential diagnosis when a mare that previously underwent a colopexy presents with severe signs of colic.


407


Fig 1: (Case 1) The original colopexy site appearing as a linear haemorrhagic area of fibrosis along the lateral free band of the left ventral colon, 48 days post colopexy.


Fig 2: (Case 1) Image showing the position of the colopexy site on the left ventral colon.


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