Comparison of surgical versus medical treatment of nephrosplenic entrapment of the large colon in horses: 19 cases (1992-2002)

摘要

The large colon can become entrapped between the left kidney and spleen (nephrosplenic entrapment of the large colon [NSELC]) or between the spleen and left body wall; both are referred to as left displacement of the large colon. It is observed more frequently in middle-aged horses, geldings, and large horses. A diagnosis of NSELC can be made by use of several methods including exploratory laparotomy Characteristically transrectal palpation reveals bands originating from the nephrosplenic space. Percutaneous ultrasonography ofthe upper portion of the left flank reveals that the image of the dorsal aspect of the spleen, and often of the kidney is obliterated by the displaced large colon. Correction of NSELC by medical (rolling, administration of phenylephrine hydrochloride [orboth], and exercise) and surgical methods has been reported. Surgical treatment is often used but has potential problems, including higher cost, a longer convalescence, and requirement for specialized equipment or a hospital facility. The purpose of thestudy reported here was to compare the effectiveness of medical versus surgical treatment as measured by in-hospital mortality rate, length of hospitalization, and cost. Our hypothesis was that medical treatment is effective and less costly than surgical treatment, making it a suitable option for field treatment.