Mesh closure of epiploic foramen by ventral laparotomy in 17 horses with entrapment

Background: Epiploic foramen entrapment (EFE) of small intestine is a severe cause of strangulating small intestinal obstruction (SSI) with long-term survival seeming lower than for other causes of SSI in horses. Different techniques via laparoscopy or laparotomy for epiploic foramen (EF) closure have been developed.
Methods: This study describes a technique of peroperative mesh closure of the EF in clinical cases and their long-term follow up.
Results: In the study period of 5.5 years 36 horses were admitted to the clinic with EFE. Of these, 17 horses had peroperative mesh closure, with resection anastomosis in 4 cases and enterotomy in 4 other cases. Fifteen of these survived to discharge. Long-term follow-up (1-6y, median 3y) was favourable in all 15 horses not showing recurrence of EFE nor other related signs of colic. Laparoscopic evaluation of the EF was performed in 2 cases and showed integration of the mesh. One horse was euthanized 3.5 years after mesh placement for an unrelated cause and the mesh was well adherent obliterating the EF.
Conclusion: Mesh closure of EF during emergency coeliotomy did not cause short-term complications even in horses with resection or enterotomy and may reduce the risk of recurrence of EFE in horses.