Equis ISSN 2398-2977

Jejunum: jejunocecostomy

Contributor(s): Steve Adair, Graham Munroe, Jarred Williams

Introduction

  • If the majority of the ileum requires resection it is recommended to perform a jejunocecal anastomosis, thereby bypassing the remnants of the ileum. If the oral most aspect of the ileum (1-25 cm) are involved, a jejunoileostomy can be performed.
  • Reasons include: the relative inaccessibility of the mid to distal ileum due to its intra-abdominal position during surgery.

Uses

  • To re-establish the continuity of the gastrointestinal tract after ileal resection.

Advantages

  • Better accessibility.

Disadvantages

  • Technically demanding.
  • Defects in mesentery must be closed to prevent potential mesenteric strangulation.
  • Risks of abdominal contamination.
  • Post-operative cecal dysfunction, kinking of jejunum, and/or colic.
  • Technically demanding.
  • Easier to perform if stapling instruments are used - increased cost.

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

  • Fair to guarded.
  • Dependent upon primary reason for surgery.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Proudman C J, Edwards G B & Barnes J (2007) Differential survival in horses requiring end-to-end jejunojejunal anastomosis compared to those requiring side-to-side jejunocaecal anastomosis. Equine Vet J 39 (2), 181-185 PubMed.
  • Rendle D I, Woodt J L, Summerhays G E, Walmsley J P, Boswell J C & Phillips T J (2005) End-to-end jejuno-ileal anastomosis following resection of strangulated small intestine in horses: a comparative study. Equine Vet J 37 (4), 356-359 PubMed.
  • Bladon B M & Hillyer M H (2000) Effect of extensive ileal resection with a large resulting mesenteric defect and stapled ileal stump in horses with a jejunocaecostomy: a comparison with other anastomotic techniques. Equine Vet J Suppl (32), 52-58 PubMed.
  • Boswell J C, Schramme M C & Gains M (2000) Jejunojejunal intussusception after an end-to-end jejunojejunal anastamosis in a horse. Equine Vet Educ 2 (6), 395-398 VetMedResource.
  • Hanson R R et al (1998) Surgical reduction of ileal impactions in the horse - 28 cases. Vet Surg 27 (6), 555-560 PubMed.
  • Freeman D E (1997) Surgery of the small intestine. Vet Clin North Am Equine Pract 13(2), 261-301 PubMed.
  • Beard W L et al (1992) Ileocecal intussusception corrected by resection within the cecum in two horses. JAVMA 200 (12), 1978-1980 PubMed.
  • Ford T S (1990) Ileocecal intussusception in horses-26 cases (1981-1988). JAVMA 196 (1), 121-126 PubMed.
  • Schumacher J et al (1987) Ileocecocolic intussusception as a sequel to jejunocecostomy in a mare. JAVMA 190 (3), 303-304 PubMed.

Other sources of information

  • Rendle D I, Boswell J C, Walmsley J P, Phillips T J & Summerhays G E S (2004)Comparison of End-to-End Jejuno-Ileal and Jejuno-Jejunal Anastomoses. In: Proc 43rd BEVA Congress. Equine Vet J Ltd, UK. pp 193.


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