Retrospective evaluation of the effect of intravenous fluid administration on development of postoperative reflux in horses with colic (2004-2012): 194 horses.

OBJECTIVE: To evaluate the role of intravenous fluid volume and electrolyte supplementation on the development of postoperative reflux (POR) in horses undergoing celiotomy for colic. DESIGN: Case-control study spanning 2004-2012 for horses undergoing celiotomy for colic. SETTING: University teaching hospital. ANIMALS: Sixty-seven client-owned horses >1 year of age with POR were each matched to 2 controls with similar surgical lesions that did not demonstrate POR. MEASUREMENTS AND MAIN RESULTS: Survival was significantly lower in cases (65.7%) than controls (96.1%). Factors found to be associated with POR included decreased net fluid volume administered on day 1 postoperatively, increased age, and performing a resection and anastomosis. Mean time until onset of POR was 20.4 hours postoperatively. PCV was significantly higher immediately following surgery and at 24 hours postoperatively in horses that developed POR compared with matched controls. There was no association between electrolyte values at presentation or administration of potassium, calcium, or magnesium in the postoperative period and the subsequent development of reflux. CONCLUSIONS: In the perioperative period, IV fluid volume overload and electrolyte abnormalities were not contributing factors in the development of POR in this population of surgical colic patients. Close postoperative monitoring with consideration and correction of pre- and postoperative fluid deficits is recommended.

Factors associated with development of ileal impaction in horses with surgical colic: 78 cases (1986-2000).

Deal impaction is prevalent in the south-eastern USA, where feeding of Coastal Bermuda hay has been implicated as a risk factor. Alternatively, infection with the tapeworm Anoplocephala perfoliata has been identified as a risk factor for ileal impaction in the UK. We hypothesised that feeding Coastal Bermuda hay and failure to administer routinely an anthelmintic with efficacy against tapeworms would place horses at risk of developing ileal impaction in the USA. Seventy-eight horses, with surgically confirmed ileal impaction and 100 horses admitted for colic that did not have an ileal impaction, were selected retrospectively for logistic regression analysis. Using odds ratios (OR) as an index of risk, feeding Coastal Bermuda hay (OR = 2.9) and failure to administer a pyrantel salt within 3 months of admission (OR = 3.1) placed horses at risk of development of ileal impaction. This study confirms the belief that feeding Coastal Bermuda hay places horses at risk of ileal impaction, although the quality of the hay may also play a role. Periodic administration of anthelmintics with efficacy against tapeworms should be considered to reduce risk of ileal impaction.

Appendiceal colic in children: a true clinical entity?

BACKGROUND: Unexplained recurrent abdominal pain is a frequent problem in the pediatric population. An organic cause is found in 10 percent of children. Recurrent abdominal pain is responsible for multiple hospital admissions and patient evaluations. In some children, partial luminal obstruction of the appendix without inflammation may be the cause of this pain, and is defined as "appendiceal colic." STUDY DESIGN: During a period of five years, we performed a prospective study among children admitted for right lower quadrant abdominal pain. Children operated on for suspected acute appendicitis were eliminated from the study. Among the remaining patients, those with recurrent pain were evaluated for appendiceal colic. Medical histories were obtained, and the patients underwent physical examinations, routine laboratory studies, stool cultures, abdominal roentgenograms, and sonography scans (including the pelvic region in girls). Precise radiologic evaluation of the appendix was performed by barium swallow in 22 children or by barium enema in four. The diagnosis of appendiceal colic was made if the following three criteria were met: a history of longer than one month with three or more recurrent attacks of right lower quadrant abdominal pain; localized tenderness in the right lower abdomen without signs of peritoneal irritation or inflammation; or radiologic findings at barium examination consisting of irregular filling of the appendix, nonfilling or partial filling of the appendix after 24 hours, or nonemptying of the appendix after 72 hours. Children thus diagnosed underwent elective appendectomy, which was performed only after an additional episode of abdominal pain. RESULTS: Twenty-six children (average age 11.4 years) were treated by appendectomy and of these, 23 (88.5 percent) experienced pain relief in the immediate postoperative period. The remaining three children had pain relief within four months after appendectomy. CONCLUSIONS: Appendiceal colic may be a true clinical entity. Children suffering from appendiceal colic may benefit from elective appendectomy.

Surgical treatment of sand colic. Results in 40 horses.

A retrospective study of 40 horses that underwent surgical treatment for sand colic was performed. Three horses were euthanatized and one died during surgery. Of the 36 horses that recovered from anesthesia, five died before discharge from the hospital and seven died after discharge. Twenty-four horses survived at least 12 months. Sand impaction of the right dorsal colon was present in 26 horses. In addition to sand impaction, 10 horses also had colonic displacement or volvulus.

Recurrent appendiceal colic.

From 1962 through 1983, 1,869 appendectomies were performed at our institution. Careful review disclosed 11 patients (0.6 per cent) who had an appendectomy for recurrent pain in the right lower abdominal quadrant not associated with other classical symptoms of appendicitis. Seven patients had an urgent diagnostic barium enema during the course of the episode of pain for which they had an appendectomy and six of the seven were abnormal. All of the patients exhibited gross abnormality of the appendix, such as fecalith (four), torsion or kinking of the appendix (three), narrowed lumen (three) and purulent material in the lumen (one). However, three specimens were thought to be histologically normal. In a follow-up study of ten of 11 patients for two weeks to 20 years, there has been no recurrence of the abdominal pain in all but one patient.