SO.P.1.4.0 Epiploc Foramen Entrapment (EFE)

Epiploic Foramen entrapment is when the small intestine gets trapped into a segment of itself thus restricting blood flow which in turn causes death to the tissue and toxins to be released into the bloodstream. In the article:

” Risk factors for epiploic foramen entrapment colic: An international study” by
AuthorsD. C. ARCHERG. L. PINCHBECKN. P. FRENCHC. J. PROUDMAN they indified in their research  that:”Crib‐biting/windsucking behaviour was strongly associated with increased risk of EFE (OR 67.3, 95% CI 15.3–296.5). A history of colic in the previous 12 months (OR 4.4, 95% CI 1.5–12.7) and horses of greater height (OR/cm 1.05, 95% CI 1.01‐1.08) were also at increased risk. The person(s) responsible for horses’ daily care (nonowner/relative/spouse OR 5.5, 95% CI 2.3–13.3) and a number of behavioural features, including response to a stimulus causing fright (easily frightened OR 0.4, 95% CI 0.1‐1.0) or excitement (sweats up easily/occasionally OR 0.3, 95% CI 0.1‐0.8), reaction to their surroundings (inquisitive OR 0.4, 95% CI 0.2‐0.8) and feeding behaviour when stressed (goes off food in full/part OR 0.3, 95% CI 0.1‐1.0) were also associated with altered risk of EFE.”

Type of colic causing small intestine strangulation

Known Causes:  Cribbing/windsucking, history of windsucking in previous 12 months, and a horse with greater height (

Pathophysiology:

“The epiploic foramen is located in the right dorsal abdomen and is bordered by the vena cava, hepatic portal vein, liver and pancreas. Most incarcerations are caused by small intestine passing from the left side of the abdomen through the epiploic foramen to the right side of the abdomen. The ileum and the jejunum are the most commonly incarcerated portions of small intestine and the length of bowel affected may vary from a few centimetres up to 17m. Strangulation of the affected portion occurs as a result of entrapment in the majority of cases and approximately 80% of affected horses have irreversible vascular compromise of the herniated small intestine”(3)

Prognosis:  If the cribbing cannot be controlled then the horse has an increased risk of developing this condition/ the treatment is surgical

References:

http://largeanimal.vethospitals.ufl.edu/2012/12/11/horse-owner-alert-cribbing-and-colic/t
Risk factors for epiploic foramen entrapment colic: An international study D. C. ARCHER*, G. L. PINCHBECK, N. P. FRENCH† and C. J. PROUDMAN P223-230 -( E-Article)
.https://en.wikivet.net/Epiploic_Foramen_Entrapment_-_Horse#Pathogenesis

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