Equis ISSN 2398-2977

Intestine: enteritis - anterior

Synonym(s): Duodenitis-Proximal Jejunitis Proximal Enteritis

Introduction

  • Cause: unknown etiology but infectious agent(s) have been postulated.
  • Signs: active and passive secretion of protein-rich fluid and electrolytes into duodenum/proximal jejunum   →   proximal small intestine distention and nasogastric reflux: acute onset of moderate to severe abdominal pain with depression, ileus, dehydration, circulatory collapse and possible death.
  • Diagnosis: difficult without exploratory laparotomy or post mortem.
  • Treatment: non-specific, supportive.
  • Prognosis: guarded with appropriate early treatment.

Pathogenesis

Pathophysiology

  • Unknown etiology.
  • Active and passive secretion of protein-rich fluid and electrolytes into the duodenum and proximal jejunum   →   proximal small intestine distention, nasogastric reflux, dehydration and circulatory shock.
  • Increased serosal permeability and hemorrhage   →   peritoneal exudation.
  • Active secretion of sodium and chloride into bowel lumen followed by water possibly caused by bacterial toxins or endogenous mediators.
  • Passive secretion of protein-rich fluid into lumen secondary to mucosal damage and submucosal inflammation in proximal small intestine.
  • Active and passive fluid secretion   →   proximal small intestine distention, dehydration and circulatory shock.
  • Small intestine ileus further contributes to intestinal distention and nasogastric reflux - may result from intramuscular hemorrhage and fibrinopurulent exudate on the serosa of the proximal small intestine.
  • Changes in serosal microvascular hemodynamics and endothelial permeability   →   protein-rich fluid exudation into the peritoneal fluid + WBC migrate through the damaged vascular barrier possibly accentuated by leakage of toxins into the peritoneal cavity.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Swain J M, Licka T, Rhind S M & Hudson N P (2003)Multifocal eosinophilic enteritis associated with a small intestinal obstruction in a standard bred horse.Vet Rec24(152), 645-651 PubMed.
  • Dewards G B (2000)Duodenitis-proximal jejunitis (anterior enteritis) as a surgical problem,Equine Vet Educ2(6), 411-414 VetMedResource.
  • Blikslager A Tet al (1994)Evaluation of factors associated with postoperative ileus in horses - 31 cases (1990-1992).JAVMA205(12), 1748-1752 VetMedResource.
  • Stadler P (1987)The anterior enteritis syndrome in the horse.J S Afr Vet Assoc58(4), 233-235 PubMed.
  • Platt H (1986) Chronic inflammatory and lymphoproliferative lesions of the equine small intestine.J Comp Pathol96(6), 671-684 PubMed.
  • Sims L Det al(1985)Haemorrhagic necrotising enteritis in foals associated with Clostridium perfringens.Aust Vet J62(6), 194-196 PubMed.


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