Stapled side-to-side anastomosis to treat a pelvic flexure stricture in a miniature horse

Abstract

Fecaliths are a recognised cause of non-strangulating colon obstruction in horses. Although they more commonly obstruct the small colon, they can also lodge in the pelvic flexure, requiring enterotomy for removal. Stricture at the enterotomy site is an uncommon but surgically significant complication. This case report describes the use of a stapled side-to-side colonic anastomosis for the treatment of a pelvic flexure stricture in a miniature horse. A 9-month-old miniature filly was referred for severe colic. Exploratory celiotomy revealed a fecalith impaction adjacent to the pelvic flexure, which was surgically managed by enterotomy. Colic recurred shortly after refeeding due to luminal narrowing at the previous enterotomy site. A second laparotomy was performed, during which a stapled side-to-side anastomosis between the ventral and dorsal colon was created at the level of the pelvic flexure. The procedure successfully relieved the obstruction and restored intestinal patency while avoiding colonic resection. Postoperative recovery was uneventful, and the filly was discharged 9 days after surgery. At 6 months postoperatively, telephone follow-up indicated no recurrence of colic. Although limited to a single case, this report suggests that stapled side-to-side colonic anastomosis may represent a useful surgical option for managing pelvic flexure strictures in horses, offering an alternative to colonic resection and potentially reducing operative time and contamination risks.