Equis ISSN 2398-2977

Jejunocolic / ileocolic anastomosis

Contributor(s): Steve Adair, Jarred Williams

Introduction

  • Cecal impaction Cecum: impaction is a relatively common disease of the cecum involving a primary cecal motility dysfunction over which there is considerable disagreement regarding treatment.
  • Surgical treatment is recommended if the cecum is very large, the impacted digesta hard, medical management is unsuccessful, or the impaction is recurrent, pain is moderate to severe, or systemic deterioration is noted.
  • Several surgical techniques are available and include typhlotomy Cecum: typhlotomy, cecocolic anastomosis Cecocolic anastomosis and jejunocolic/ileocolic anastomosis.
  • Jejunocolic/ileocolic anastomoses are more recently developed surgical techniques designed to completely or incompletely bypass the cecum.

Uses

  • Surgical treatment of cecal impaction Cecum: impaction or cecocolic intussusception to prevent recurrent impaction and subsequent perforation.
  • Often combined with typhlotomy Cecum: typhlotomy and evacuation of cecal contents.

Advantages

  • Jejunocolic/ileocolic anastomosis is the most successful bypass procedure for treatment of cecal impaction.
  • Can be used if cecal wall is compromised.

Disadvantages

  • Technically demanding.
  • Easier to perform if stapling instruments are used - increased expense.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • See Cecum: impaction.
  • Incomplete side-to-side ileocolic anastomosis did not prevent cecal filling in the original description of the technique, but complete ileocolic anastomosis was successful.
  • Incomplete jejunocolic anastomosis was successful in preventing recurrence of cecal impaction in one horse.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Freeman D E (2008) Options for treatment of cecocolic intussusception in horses. J Am Vet Med Assoc 232 (8), 1134 PubMed.
  • Lores M & Ortenburger A I (2008) Use of cecal bypass via side-to-side ileocolic anastomosis without ileal transection for treatment of cecocolic intussusception in three horses. J Am Vet Med Assoc 232 (4), 574-577 PubMed.
  • Symm W A, Nieto J E, Van Hoogmoed L & Snyder J R (2006) Initial evaluation of a technique for complete cecal bypass in the horse. Vet Surg 35 (7), 674-677 PubMed.
  • Boswell J C, Schramme M C & Gains M (2000) Jejunojejunal intussusception after an end-to-end jejunojejunal anastomosis in a horse. Equine Vet Educ 2 (6), 395-398 PubMed.
  • Dabareiner R M and White N A (1997) Diseases and surgery of the cecum. Vet Clin North Am Equine Pract 13 (2), 303-315 PubMed.
  • Gerard M P, Bowman D F, Blikslager A T, Tate L P Jr and Bristol D G (1996) Jejunocolostomy or ileocolostomy for treatment of cecal impaction in horses - nine cases (1985-1995). JAVMA 209 (7), 1287-1290 PubMed.
  • Mueller P O and Allen D (1996) Instrumentation and techniques in equine gastrointestinal surgery. Vet Clin North Am Equine Pract 12 (2), 207-233 PubMed.
  • Ward J L & Fubini S L (1994) Partial typhlectomy and ileocolostomy for treatment of nonreducible cecocolic intussusception in a horse. J Am Vet Med Assoc 205 (2), 325-328 PubMed.
  • Ross M W (1989) Surgical diseases of the equine cecum. Vet Clin North Am Equine Pract 5 (2), 363-375 PubMed.
  • Ross M W, Orsini J A and Ehnen S J (1987) Jejunocolic anastomosis for the surgical management of recurrent cecal impaction in a horse. Vet Surg 16 (4), 265-268 PubMed
  • Craig D R, Pankowski R, Hackett R P et al (1987) Ileocolostomy - A technique for surgical management of equine cecal impactions. Vet Surg 16 (6), 451-455 PubMed.


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