Horse, thoroughbred, 6 month, female.
Diagnosis: Stomach: Acute, severe gastric rupture
Description: The entire gastric-wall (seromuscularis and mucosa) ruptured along a line parallel to the greater curvature over a distance of 30.0 cm. The margin had a staircase-shaped appearance and showed acute haemorrhage. Constituent parts of forage were released (liberated) to the cranial abdominal cavity. Correspondingly a severe, diffuse, acute peritonitis was present. The stomach was filled with 17.0 kg of dry, ingesta which was rich in fibres. Additionally the pelvic flexure of the Colon ascendens was mildly constipated by dry ingesta.
Comments: The foal was found in the state of shock with striking abdominal distension. The laboratory parameters showed a leukopenia, an severely elevated PCV and an increased peritoneal total protein. There was no recovery of gastric fluid by naso-esophageal tube. The horse was euthanized due to poor prognosis. Gastric ruptures have a prevalence of 1 to 8 % in cases of colic. Most ruptures in horses are located on a line parallel with the greater curvature, often about 5 cm medial to it. In general, gastric ruptures are biphasic processes. As indicated by the staircase-shaped appearance, where the seromuscular tear is generally longer than the mucosal, the seromuscularis usually weakens first. More than two-thirds of gastric ruptures are secondary to ileus, mechanical obstruction or trauma. Primary gastric ruptures result from overload or other idiopathic causes. In contrast to adult horses, where ulcerations rarely lead to perforation, in foals they do. The cause of Gastroduodenal ulcer disease (GDUD) in foals younger 1 year is unknown, but duodenal strictures are a deleterious consequence of GDUD. In the presented case, there were no signs of gastric ulceration.
Picture by: Marie-Charlotte von Deetzen, Department of Veterinary Pathology, Freie Universität Berlin, Germany
Author: Cornelia Holzhausen, Department of Veterinary Pathology, Freie Universität Berlin, Germany