Strangulating lesions of the small intestine associated with the greater omentum in horses: 29 cases (2005-2018)

Introduction - Strangulating lesions of the small intestine related to the greater omentum are rarely reported. The objective of this study is to describe the prevalence, clinical presentation, surgical findings and post-operative outcome of these lesions.

Materials and methods - A retrospective case series included 29 horses with a surgical diagnosis of strangulating lesion of the small intestine associated with the greater omentum. Signalment, clinical and surgical findings, procedures and post-operative outcome were analyzed.

Results - Surgical findings included strangulating lesions associated with adhesions of the greater omentum (13/29) or with pedunculated lipoma-like structures arising from the greater omentum (7/29), direct strangulation of the small intestine by the greater omentum (6/29) or incarceration through an omental rent (3/29). Prevalence of strangulating lesions associated with the greater omentum was present in 2.3% (29/1284) of all horses undergoing exploratory laparotomy for colic, represented 4.5% (29/638) of all horses with primary small intestinal lesions and 5.3% (29/547) of strangulating lesions. Short-term survival rate was 52% (15/29). No breed, sex or age predilection was detected.

Discussion – Although infrequent, strangulating lesions of the small intestine associated with the greater omentum should be included in the differential diagnosis of small intestine strangulation. Definitive diagnosis was only permitted during surgery. Omentectomy could be considered as a prevetive measure to limit occurrence or recurrence.