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Use of Pelvic Flexure Biopsies to Predict Survival After Large Colon Torsion in Horses

Authors

  • Linda Van Hoogmoed DVM, PhD, Diplomate ACVS,

    1. From the Comparative Gastroenterology Laboratory, Department of Surgical and Radiological Sciences and the Department of Pathology, School of Veterinary Medicine, University of California, Davis, CA.
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  • Jack R. Snyder DVM, PhD, Diplomate ACVS,

    1. From the Comparative Gastroenterology Laboratory, Department of Surgical and Radiological Sciences and the Department of Pathology, School of Veterinary Medicine, University of California, Davis, CA.
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  • John R. Pascoe BVSc, PhD, Diplomate ACVS,

    1. From the Comparative Gastroenterology Laboratory, Department of Surgical and Radiological Sciences and the Department of Pathology, School of Veterinary Medicine, University of California, Davis, CA.
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  • Harvey Olander DVM, PhD, Diplomate ACVP

    1. From the Comparative Gastroenterology Laboratory, Department of Surgical and Radiological Sciences and the Department of Pathology, School of Veterinary Medicine, University of California, Davis, CA.
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  • Supported by funds from private donors.

  • Presented at the Equine Colic Symposium, November 1998, Atlanta, GA, and the 8th Annual American College of Veterinary Surgery Symposium, October 1998, Chicago, IL.

  • No reprints available.

Jack R. Snyder, DVM, PhD, Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616.

Abstract

Objective— To determine if morphologic evaluation of intraoperative biopsies of the large colon could be used to accurately predict outcome in horses with large colon torsion.

Study Design— Clinical study.

Animals— Fifty-four horses with large colon torsion.

Methods— A full-thickness biopsy was collected from the pelvic flexure of the ascending colon after correction of naturally occurring colonic torsion. Morphologic changes were evaluated and graded for interstitial tissue to crypt ratio (I:C ratio), percentage loss of superficial and glandular epithelium, and the degree of hemorrhage and edema. These variables were then used to predict survival.

Results— Morphologic variables could be used to correctly predict survival or death in 51 horses (P < .0001). This corresponded to a sensitivity of 95.1% (82.2%-99.2%; 95% CI) and a specificity of 92.3% (62.0%-99.6%; 95% CI). Of 6 horses that had colonic resection, 5 survived; an accurate prediction of outcome based on morphologic criteria was made for each horse.

Conclusions— Interpretation of changes in colonic morphology can be used to accurately predict postoperative survival in horses with large colon torsion.

Clinical Relevance— Use of frozen colonic tissue sections is a rapid, reliable, and relatively inexpensive method for assessing morphologic damage associated with large colon torsion during surgery. Intraoperative evaluation of pelvic flexure biopsies can aid in the prediction of survival and guide surgical judgment as to the need for colonic resection.

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