ISSN 2398-2977      

Colon: displacement - left dorsal

pequis

Synonym(s): Nephrosplenic entrapment, renosplenic entrapment


Introduction

  • Displacement of the ascending colon between the dorsal abdominal wall, the left kidney, the nephrosplenic ligament and the dorsal border of the spleen.
  • Cause: unknown.
  • Signs: increasing pain, reduced fecal output, tympany, few systemic signs. Occasionally peracute.
  • Diagnosis: rectal examination, ultrasonography.
  • Treatment: surgery, rolling (needs experience), medical treatment, including use of phenylephrine.
  • Prognosis: good if there is no marked vascular compromise of the colon wall.

Pathogenesis

Etiology

  • Uncertain.
  • May be a combination of tympany of the left colon and rapid splenic contraction.
  • Gastric dilatation may cause spleen to move away from abdominal wall creating room for colon to move into.

Predisposing factors

General
  • Gelding.
  • Large breed (large framed Warmblood types).

Pathophysiology

  • Displacement of ascending colon into nephrosplenic space   →   obstruction   →   accumulation of ingesta and gas.
  • Tympany of left colon and splenic contraction   →   colon moves dorsally, usually from a cranial direction   →   spleen refills and its base hooks under colon   →   colon trapped under left kidney   →   colon may herniate into nephrosplenic space as far as the middle of the right dorsal and ventral colon   Colon: displacement 01 - left dorsal (diagram)    Colon: displacement 02 - left dorsal (diagram)  .
  • Entrapment may be complete (edge of spleen laterodorsal to colon) or partial (edge of spleen ventral to colon).
  • Spleen usually engorged; nephrosplenic ligament stretched.
  • Colon over nephrosplenic ligament is usally rotated 180° along its long axis   →   ventral colon lies above dorsal colon.
  • Diaphragmatic and sternal flexures lie between the stomach and the left lobe of the liver.

Timecourse

  • Usually protracted course, occasionally peracute (shock within 3-6 h).

Epidemiology

  • Usually seen in mature geldings of large breeds.

Diagnosis

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Treatment

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Prevention

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Albanese V & Caldwell F J (2014) Left dorsal displacement of the large colon in the horse. Equine Vet Educ 26 (2), 107-111 VetMedResource.
  • Monreal L et al (2010) Enteral fluid therapy in 108 horses with large colon impactions and dorsal displacements. Vet Rec 166 (9), 259-263 PubMed.
  • Marien T, Adrianssen A, Hoeck F V & Segers L (2001) Laparoscopic closure of the renosplenic space in standing horses. Vet Surg 30, 559-563 PubMed.
  • Van Haverveld P D, Cox J & Biller D S (1999) Phenylephrine HCl as a treatment of nephrosplenic entrapment in a horse. Equine Vet Educ 11 (6), 282-284 VetMedResource.
  • Burba D J & Moore R M (1997) Renosplenic entrapment: a review of clinical presentation and treatment. Equine Vet Educ (4), 180-184 VetMedResource.
  • Parks A H (1996) Displacement of the large colon - conservative versus surgical management. Comp Cont Educ Pract Vet 18 (1), 84 VetMedResource.
  • Kalsbeck H C (1989) Further experience with non-surgical correction of nephrosplenic entrapment of the left colon in the horse. Equine Vet J 21 (6), 442-443 VetMedResource.

Can’t find what you’re looking for?

We have an ever growing content library on Vetlexicon so if you ever find we haven't covered something that you need please fill in the form below and let us know!