Equis ISSN 2398-2977

Large colon: intussusception

Contributor(s): Graham Munroe

Introduction

  • Cause: abnormality of gut motility leads to intussusception of large colon but only rarely because of anatomical design of structure.
  • Pelvic flexure and left ventral/dorsal colon predisposed.
  • Signs: mild or severe recurrent abdominal pain depending on severity of intussusception in young animals with history of previous bowel disease.
  • Diagnosis: rectal palpation and exploratory laparotomy.
  • Treatment: surgical, either by manual reduction or resection and anastomosis.
  • Prognosis: good to guarded depending on individual case circumstances.

Pathogenesis

Etiology

  • Unknown.
  • Possibly hypermotility secondary to other bowel disease.

Predisposing factors

General
  • Causes of abnormal gut motility:
    • Impaction.
    • Diarrhea.
    • Parasites.
    • Bowel masses.
  • Predisposed segments because of anatomical arrangements:
    • Pelvic flexure.
    • Left ventral colon.
    • Left dorsal colon.

Pathophysiology

  • Rare condition compared to small intestinal intussusception   Gastrointestinal: small intestine - intussusception  due to short, strong intercolonic mesentery.
  • Predisposition from abnormal motility, impaction, diarrhea and parasite lesions, including tapeworm   Anoplocephala spp  .
  • Solid masses in or on the bowel wall may form the leading edge of the intussusception in other parts of the intestine and similar effects in the large colon are possible.
  • Predisposed segments of large bowel may include pelvic flexure, left ventral colon and left dorsal colon. The right colon segments have dorsal mesenteric attachments and in the right ventral colon the cecocolic ligament make intussusception less likely.
  • Formed intussusception initially rarely completely occludes the bowel lumen and continues to allow passage of loose feces.
  • Later on simple bowel obstruction will occur.
  • Further intussusception   →   venous obstruction, edematous swelling of the colon wall, and finally, in severe cases, arterial oclusion and strangulating obstruction.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Albanese Vet al(2011)A case of a colocolic intussusception in a horse.Equine Vet Educ23(6), 281-285 VetMedResource.
  • Wilson D Get al(1983)Intussusception of the left dorsal colon in a horse.JAVMA183(4), 464 PubMed.
  • Robertson J T & Tate L P Jr (1982)Resection of intussuscepted large colon in a horse.JAVMA181(9), 927-928 PubMed.


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