The jejunocecal anastomosis is one 01 the most challenging with a purported high postoperative complication rate. The worst intraoperative complication is realized when the anastomosis is complete and the surgeon proceeds with closing the mesenteric defect and it becomes apparent that the bowel has been rotated 360° around the root of the mesentery and the jejunum has been anastomosed to the cecum incorrectly. The mesenteric defect cannot be closed in this situation and postoperative reflux and colic associated with obstruction are likely to occur. The key with preventing this complication lies in avoiding resection of the mesentery too close to the root so as to leave enough for closure; beginning to close the mesenteric defect prior to commencingthe anastomosis to ensure that closure can be completed; and maintaining the orientation of the jejunum and its mesentery on the left side of the horse's abdomen. A recent approach has also been described where the jejunal-cecal anastomosis is performed prior to the bowel and mesenteric resection.1
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