Reincidência de encarceramento do forame epiploico em equino no pós-operatório imediato: relato de caso

Abstract

Intestinal loop incarceration within the epiploic foramen (EF) in horses is a critical surgical condition demanding prompt intervention. It is linked to equines displaying aerophagia behavior and, postoperatively, complications may necessitate a secondary intervention during hospitalization, with rare instances of recurrence in the medium to long term. This study aims to document a case of epiploic foramen incarceration occurring during a 15-day postoperative period in a 13-year-old male Brazilian Show Jumper horse attended to by the large animal surgery department of the Veterinary Hospital at the Federal University of Minas Gerais (HV-UFMG). The horse, with a history of aerophagia, initially exhibited moderate colic signs escalating to severe pain. On-site examination revealed nasogastric reflux, dry oral mucosa with a capillary refill time of 3 seconds. The HV-UFMG clinical examination indicated 8-10% dehydration, a capillary refill time of 4 seconds, and an endotoxic halo in the oral mucosa. Ultrasonographic examination disclosed distended small intestinais loops throughout the abdominal cavity. In surgery, colic's cause was identified as small intestinal loop strangulation through the epiploic foramen. The incarceration was corrected, necessitating segment resection and jejunocecostomy. Post-correction, the EF diameter was noted to be 7 cm, surpassing the normal 4 cm. Fifteen days postoperatively, the horse presented severe acute abdominal pain unresponsive to analgesics and sedatives. A second surgical intervention unveiled a fresh incarceration in the epiploic foramen with extensive devitalization of the involved segment, rendering surgical correction unviable and leading to the decision for euthanasia. This rare and underreported condition raises suspicions of equine-specific factors, notably persistent aerophagia, a weight of 550 kg and an enlarged EF diameter, potentially contributing to recurrence.