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Background and Aims Endoscopic mucosal resection (EMR) has become the standard for removing large colon polyps but has a 10%-30% recurrence rate using standard techniques. Data shows improved recurrence rates with focal therapy of the edge of the resection base using cautery. We examine a novel technique, hybrid APC assisted EMR, which treats both the edge and the base with cautery to assess its effect on local recurrence. Methods We reviewed all EMRs of polyps >2 cm by a single endoscopist with 6-month follow-up from May 2018 to November 2019 using both standard EMR as well as hybrid APC assisted EMR to assess local recurrence as well adverse events. Results Forty-eight patients with 59 polyps removed by EMR had full 6 month follow up with a mean age of 66.1 years of age, 45% were female. Thirty polyps were removed by hybrid APC assisted EMR and 29 removed with standard EMR. Overall, 0 (0%) polyps in the h-APC arm had local recurrence while 6 (20.7%) in the standard group had histological proven local recurrence (P = 0.01). Postresection bleeding occurred in 6 patients, 2 in the hAPC arm and 4 in the standard arm (P = 0.41). Conclusion In this retrospective pilot study, hybrid APC assisted EMR was superior to conventional EMR for local recurrence after removal of large colon polyps and trended towards a less post-EMR bleeds.

This study aimed to evaluate the efficiency of flank laparotomy to obtain intestinal biopsies in horses, as well as the occurrence of complications associated with the procedure. Sixteen healthy adult horses, mixed-breed, four males and 12 females, aged between four and 14 years and mean body weight of 248.40 + 2.28 kg were used. All animals underwent two flank laparotomies for collection of intestinal biopsies, jejunum and large colon, with an interval of 144 hours between collections. Incisional complications were observed in 90% of the animals, including seroma/incisional line infection, and suture line dehiscence. Despite the occurrence of complications, the procedure proved to be easy to perform and suitable for obtaining intestinal biopsies. Este estudio tuvo como objetivo evaluar la eficacia de la laparotomía de flanco para obtener biopsias intestinales en caballos, así como la ocurrencia de complicaciones asociadas al procedimiento. Se utilizaron dieciséis caballos mestizos, sanos, adultos, cuatro machos y 12 hembras, con edades comprendidas entre los cuatro y los 14 años y peso corporal medio de 248,40 + 2,28 kg. Todos los animales se sometieron a dos laparotomías de flanco para recolectar biopsias intestinales, de yeyuno y de colon grande, con un intervalo de 144 horas entre las recolectas. Se observaron complicaciones de la incisión en el 90 % de los animales, incluida la infección / seroma de la línea de incisión y la dehiscencia de la línea de sutura. Apesar de la ocurrencia de complicaciones, el procedimiento demostró ser fácil de realizar y adecuado para la obtención de biopsias intestinales. Este estudo teve por objetivo avaliar a eficiência da laparotomia pelo flanco para obtenção de biópsias intestinais em equinos, bem como a ocorrência de complicações associadas ao procedimento. Foram utilizados 16 equinos adultos hígidos, sem raça definida, quatro machos e 12 fêmeas, com idade variando entre quatro e 14 anos e peso corporal médio de 248,40 + 2,28 kg. Todos os animais foram submetidos a duas laparotomias pelo flanco para coleta de biopsias intestinais, jejuno e cólon maior, com intervalo de 144 horas entre as coletas. Complicações incisionais foram observadas em 90% dos animais incluindo seroma/infecção da linha incisional e deiscência da linha de sutura. Apesar da ocorrência de complicações, o procedimento demonstrou-se de fácil realização e adequado para obtenção de biopsias intestinais.

Background Evidence is lacking concerning re‐introduction of feed and water following colic surgery. Objectives To describe current approaches of European and American specialists to re‐introduction of feed and water in adult horses following surgical treatment of common intestinal lesions, assuming an uncomplicated recovery. Study design Cross‐sectional survey. Methods Electronic invitations, with a link to the online survey, were sent to 1,430 large animal specialists, including Diplomates of the ECVS, ACVS, ECEIM and ACVIM colleges. Results The response rate was 12.6% including partial respondent data. Responses for each multiple‐choice question were between 123 and 178. Results are expressed as the percentage of the total number of responses and as a range where specific lesions are grouped together. Respondents reported that horses with large intestinal displacements were offered free choice water (63%‐65%) within 3 hours (55%‐63%), whereas horses with a small intestinal strangulating lesion were offered

OBJECTIVE To determine the degree of histomorphometric damage in dorsal colon and pelvic flexure biopsy specimens (DCBSs and PFBSs, respectively) obtained from horses with large colon volvulus (LCV) and assess the accuracy of predicting short-term outcome for those horses on the basis of DCBS or PFBS characteristics. ANIMALS 18 horses with ≥ 360° LCV that underwent large colon resection. PROCEDURES During surgery, biopsy specimens from the dorsal colon resection site and the pelvic flexure (when available) were collected from each horse. Interstitial-to-crypt (I:C) ratio (ratio of the lamina propria space occupied by the interstitium to that occupied by crypts), hemorrhage within the lamina propria (mucosal hemorrhage score [MHS] from 0 to 4), and percentage losses of glandular and luminal epithelium were determined in paired biopsy specimens and compared to determine optimal cutoff values for calculating the accuracy of DCBS and PFBS characteristics to predict short-term outcome (survival or nonsurvival after recovery from surgery). RESULTS Paired biopsy specimens were obtained from 17 of the 18 horses. The I:C ratio and percentage glandular epithelial loss differed between DCBSs and PFBSs. For DCBSs, an I:C ratio ≥ 0.9 and MHS ≥ 3 each predicted patient nonsurvival with 77.8% accuracy. For PFBSs, an I:C ratio ≥ I and MHS ≥ 3 predicted patient nonsurvival with 70.6% and 82.4% accuracy, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Although different, histomorphometric measurements for either DCBSs or PFBSs could be used to accurately predict short-term outcome for horses with LCV that underwent large colon resection, and arguably PFBSs are easier to collect.

Objective To determine the prognostic value of (1) colonic venous lactate or peripheral lactate values obtained before and after manual correction of a large colon volvulus and (2) a combination of variables including pelvic flexure biopsy. Study design Prospective clinical study. Animals Forty adult horses in which large colon volvulus was diagnosed intraoperatively. Methods Colonic venous, peripheral venous, and arterial blood samples were collected to measure lactate values before and after manual correction. Mucosal biopsy samples were obtained in cases that underwent enterotomy or colonic resection and anastomosis. Interstitium to crypt (I:C) ratio and hemorrhage scores were measured. Optimal cutoff values were determined by receiver operator curve analysis, and associations between variables and short-term outcome were determined by univariable regression. Short-term survival was defined as horses being discharged from the hospital. P ≤ .05 was considered significant. Results No association was found between colonic venous lactate values before (P = .011) or after (P = .201) manual correction of large colon volvulus and determination of short-term outcome. Peripheral venous lactate at admission ≥3.2 mmol/L and after manual correction ≥5 mmol/L, arterial lactate postmanual correction ≥3.53 mmol/L, and histomorphometric measurements of mucosal hemorrhage ≥3 and I:C ratio > 1 were associated with poor short-term outcome. Conclusion Peripheral lactate values, histomorphometric measures of I:C ratio, and hemorrhage score provided prognostic information that could help guide recommendations made to owners. Clinical significance Peripheral lactate values after manual correction provide important intraoperative diagnostic information to assist in predicting case outcome in the operative and immediately postoperative period.

Clinical problems related to intestinal sand accumulation in horses are common in certain geographic areas, but the clinical signs appear nonspecific and the course of the accumulation remains somewhat obscure. This study examined the association between the presence and size of intestinal sand accumulations and owner-reported clinical signs, management, and feeding practices, as well as behavioral patterns in horses with radiographic diagnosis of sand accumulation. Owners of the horses filled in an online questionnaire. A total of 447 responses met the inclusion criteria. The size of the sand accumulation detected in the radiographs was not significantly associated with the age, body condition score, sex, or use of the horses. Horses reported to have expressed colic had significantly larger sand accumulations than those without this sign, and a similar association was detected in horses with poor performance. The highest odds ratio for sand accumulation was for the combination of colic and poor performance, followed by colic combined with diarrhea/loose feces or hyperesthesia to touch of the abdominal wall. Larger sand accumulations were detected in greedy horses that eat all their roughage, whereas dominant position in group hierarchy was associated with less sand. The possibility of abdominal sand accumulation should be considered as one of the differentials in horses with multiple owner-reported clinical signs such as colic, poor performance, diarrhea, and hyperesthesia to touch of the abdomen. (C) 2019 The Authors. Published by Elsevier Inc.

Background: Endoscopic polypectomy is an accepted procedure for prevention of colorectal cancer. Yet, large and difficult polyps present a technical and medical challenge to correct treatment. Objective: The aim of this study was to report and analyze the experience in the treatment of large colon polyps. Material and methods: We analyzed the endoscopic resection of large colon polyps performed between January 2006 and March 2018. Results: Of 3397 lower gastrointestinal endoscopies, 22 patients underwent resection of 25 large polyps (0.64%). There were no complications or deaths in the series. Conclusions: Endoscopic resection of large colon polyps is feasible and safe in lesions > 20 mm in diameter. The procedure serves both as biopsy or definite treatment and is an additional tool for the surgeon who has the capability of dealing with the complications or completing with surgery.

Background: The presence of neutrophil-rich inflammation in colon tissues of patients with ulcerative colitis (UC) is one of the most important histological characteristics of this disease. However, the expression of CXCL chemokines governing the infiltration of neutrophils in UC has not been well elucidated. Materials and methods: In this experimental study, the UC model was induced in Wistar rats by administration of 2 mL 4% acetic acid into the large colon through the rectum. Animals were anesthetized after 48 hrs; their colon tissue samples were isolated for macroscopic and histopathological examinations. The expression of CXCL family was assessed by reverse transcription polymerase chain reaction (qRT-PCR) technique. Results: Heavy infiltration of neutrophils, coagulation necrosis, and ulcers were observed in HE therefore, CXCL6 and CXCL3 chemokines can be used as therapeutic targets for UC, although more studies using human samples are required.

Management factors associated with colic, particularly related to stall confinement and nutrition, have been linked to alterations in gastrointestinal mucosal transport, motility, and microbiome, which in turn creates conditions that induce colic. In particular, meal feeding creates large changes in water movement in and out of the colon and alters the microbiome. These conditions may in turn result in colic conditions such as large colon impaction or large colon volvulus. In addition, a range of management and nutritional factors have been found to place horses at risk of select colic conditions such as ileal impaction. Other specific colic conditions, such as strangulating lipomas, may be related to fat metabolism in geldings and ponies, although the association with nutrition and the endocrine system are less well defined. It has long been understood that parasites are associated with colic, and with the advent of highly effective anthelmintics, parasite-induced colic has been markedly reduced. Nonetheless, equine mangers and veterinarians have to be aware of changes in parasite resistance or patterns of activity, such as the resurgence of large strongyles with surveillance-based management of parasites. Overall, understanding management risk factors can lead to recommendations that prevent colic in horses. Additional study of these factors may ultimately lead to reductions in the prevalence of colic by suggesting optimal management practices.

Snare entrapment is a rare complication of hot snare polypectomy of large colon polyps. We report a case of snare entrapment in our unit and its management. This report highlights the method of delayed removal of snare followed by repeat colonoscopy.

To resolve large colon impactions, frequent enteral administration of large volumes of water (8-10 liters in a 500 kg horse) has been suggested. Furthermore, in large colon volvulus, the simultaneous presence of gastric impaction has been described as a possible predisposing factor. To describe the clinical and surgical features of horses with large colon volvulus associated with aggressive enteral fluid therapy performed to resolve an initial large colon impaction. Records of horses that underwent exploratory laparotomy at the Veterinary Teaching Hospital of Turin between 2012-2019 were reviewed. Clinical and surgical features of cases initially diagnosed with large colon impaction that developed a large colon volvulus after enteral administration of large volumes of fluids were retrieved. Four horses met the criteria. In all horses an initial diagnosis of large colon impaction was made by the referring veterinarian. In all cases a sudden increase in pain was noticed shortly after enteral administration of large volumes (8-10 liters) of water. Administration of analgesic didn't resolve the pain in any of the horses that were then referred. A large colon volvulus was found during exploratory laparotomy in all cases. A moderate gastric impaction was also found intraoperatively, which was confirmed by gastroscopy postoperatively. Nasogastric administration of large quantity of fluids with a pre-existing gastric and colon impaction, may reduce the available space in the abdominal cavity and potentially predispose the colon volvulus. More frequent enteral administration of smaller volumes of fluids might be preferred when treating large colon impactions.

This report describes successful surgical correction and long-term survival of a case of large colon atresia in a 24-h-old Warmblood colt, referred with signs of unrelenting abdominal pain and a suspicion of meconium impaction. Radiographic and ultrasonographic examination was indicative of large colon meconium impaction with secondary ileus. Due to deterioration of the foal, surgery was recommended. An atretic segment was found between the left ventral and dorsal large (ascending) colon. A band of fibrous tissue with no identifiable lumen connected the segments. Surgical correction was done by performing a stapled side-to-side anastomosis. Twelve days after surgery, the foal was discharged. Twenty-two months after discharge, the owner reported the foal developing as expected compared with its peers, but had a mild, self-limiting episode of colic at 20 months of age.

Large colon volvulus in horses is associated with a poor prognosis, especially when ischemic-reperfusion injury of the affected intestinal tract develops. Proteinase-activated receptor 2 (PAR2) plays an important role in the pathogenesis of inflammation in the gastrointestinal tract. The aim of this study was to evaluate the distribution and expression of PAR2in colonic pelvic flexure of horses spontaneously affected by large colon volvulus (CVH group). Eight horses admitted for severe abdominal colon volvolus and which underwent surgery were included. Colon samples were collected after enterotomy. Data previously obtained from healthy horses were used as a control group. Histologic evaluation was carried out to grade the severity of the colon lesions. Immunofluorescence, western blot and quantitative polymerase chain reaction (RT-qPCR) were carried out on colon samples to evaluate PAR2expression. In addition, the transcriptional profile of cytokines and chemokines was evaluated using RT2Profiler™ PCR Array Horse Cytokines & Chemokines. Three out of the eight patients were euthanised due to clinical deterioration. Immunostaining for PAR2was observed in the enterocytes, intestinal glands and neurons of the submucosal and myenteric plexi. In the CVH horses, the expression of PAR2mesenger RNA (mRNA) did not differ significantly from that of the healthy animals; western blots of the mucosa of the colon tracts showed a clear band of the expected molecular weight for PAR2(~44 kDa) and a band smaller than the expected molecular weight for PAR2(25kDa), suggesting its activation. The gene expressions for C-X-C motif ligand 1 (CXCL1); interleukin 8 (IL8), macrophage inflammatory protein 2 beta (MIP-2BETA) were upregulated in the colic horses as compared with the colons of the healthy horses. Therefore, in the present study, the expression and activation of PAR2in the colons of horses in the presence of an inflammatory reaction like that occurring in those with spontaneous colon volvulus was confirmed.

Rectal perforation is a rare cause of acute abdomen. The most common cause of rectal perforation is trauma. Barotrauma due to the injection of compressed air in the rectum is an extremely rare cause of rectal perforation. We report a case of extensive pneumoperitoneum with abdominal compartment syndrome caused by rectal perforation secondary to the forceful injection of compressed air through the perineum. The patient was successfully managed by immediate relief of abdominal compartment syndrome by needle decompression followed by surgical repair of rectal perforation.

Simple Summary Acute diarrhea (colitis) is a major problem in adult horses and the role of the intestinal bacteria (microbiota) is still poorly understood in this species. The aim of this study was to compare the mucosal and luminal content microbiota of the cecum and colon of healthy and diarrheic horses. We concluded that microbial dysbiosis (changes in the normal microbiota composition) occurs in horses with colitis at different levels of the intestinal tract and microbiota composition is different between the mucosa and luminal content of diarrheic horses. Changes in species associated with dysbiosis could be used in the future for disease diagnosis, prognosis and treatment of equine colitis. Abstract The aim of this study was to compare the mucosal and luminal content microbiota of the cecum and colon of healthy and diarrheic horses. Marked differences in the richness and in the community composition between the mucosal and luminal microbiota of the cecum and large colon of horses with colitis were observed. Microbial dysbiosis occurs in horses with colitis at different levels of the intestinal tract, and microbiota composition is different between the mucosa and luminal content of diarrheic horses. The changes in some key taxa associated with dysbiosis in the equine intestinal microbiota, such as Escherichia, Fusobacterium and Lactobacillus, deserve further inquiry in order to determine their utility for disease diagnosis and treatment.

A variety of treatment strategies for nephrosplenic entrapment of the large colon are reported, with conflicting evidence in the published literature as to the preferred treatment option. The aim of this study is to provide a systematic meta-analytical assessment of the efficacy of different treatment strategies in horses with confirmed or suspected nephrosplenic entrapment. This study involves meta-analysis including nonrandomized studies. A comprehensive literature search was performed from January 1970 to January 2017. Inclusion criteria were retrospective studies involving horses with confirmed and suspected nephrosplenic entrapment. A meta-analysis was performed using a random effects model, with the effect size calculated as an odds ratio (OR) with 95% confidence intervals. Statistical significance was P.05. Out of 84 peer reviewed publications that met the search criteria, 19 relevant studies were identified. Using an OR as the effect size, the meta-analysis noted that the choice of medical or surgical therapy had no statistically significant effect on survival (P = .134). Patients treated via the rolling technique were no more likely to resolve with medical management than those treated via jogging (P = .187). Patients treated with phenylephrine were no more likely to exhibit medical resolution than patients that did not receive phenylephrine, either when all medical treatment methods were considered (P = .290), or when rolling under general anesthesia was used (P = .331). Treatment strategy, including medical versus surgical therapy, does not affect the likelihood of resolution of nephrosplenic entrapment. However, the lack of randomized trials means the results should be treated with caution and case selection remains important..

Identifying therapies that mitigate ischemic colonic injury and improve mucosal healing and intestinal viability are crucial to improving survival in horses with ≥360° large colon volvulus (LCV). Ethyl pyruvate is the ethyl ester of pyruvate with diverse pharmacologic effects that limit ischemic injury and hasten intestinal mucosal repair in preclinical rodents, sheep and swine models. The objective of this study was to determine the effects of ethyl pyruvate on systemic indices of colon viability, expression of inflammatory genes in whole blood, morbidity and survival after surgical correction of LCV compared to controls. Horses received either 150 mg/kg ethyl pyruvate in 1 liter lactated Ringer's solution (LRS) or 1 liter LRS intravenously (IV) every 6 h for 24 h following surgical recovery for correction of LCV. Colic duration, perioperative heart rate (HR), packed cell volume (PCV), total solids (TS), blood L-lactate concentration, surgical time, intraoperative episodes of hypoxemia and hypotension, expression of inflammatory cytokine genes, fecal consistency and survival to hospital discharge were compared between ethyl pyruvate treated horses and controls. Twenty-two horses, 12 receiving ethyl pyruvate and 10 controls, were enrolled in the study. Ethyl pyruvate was safely administered to horses following surgical correction of LCV. No significant effects of ethyl pyruvate on post-operative variables, including survival, were found. Seven of 12 ethyl pyruvate treated horses and 5/10 controls survived to hospital discharge. Higher HR, PCV and blood L-lactate concentration at the time of hospital admission, P = 0.005, 0.01, 0.04, respectively, 24 h after surgery, P = 0.001, 0.03, 0.02, respectively, were associated with death. Heart rate, P = 0.005, 48 h after surgery was associated with death. Ethyl pyruvate was safely administered to horses following correction of LCV with no apparent adverse events but was not associated with improved post-operative outcomes including survival. A larger, randomized control trial is needed to fully evaluate the effectiveness of ethyl pyruvate. A major limitation of this investigation is the small sample size, making the study underpowered and creating a high possibility of type II error.

Enteropathy associated with sand accumulation in the large colon of horses has been reported worldwide. Intestinal sand accumulations are commonly treated medically, but randomised controlled clinical trials on horses are scarce. This prospective study evaluated the efficacy of an enterally administered combination of psyllium and magnesium sulphate (MgSO4) for the removal of large colonic sand accumulations in horses without clinical signs of acute colic. The two groups comprised 20 untreated control horses and 20 horses treated with 1 g/kg bodyweight (bwt) of psyllium and 1 g/kg bwt of MgSO4 administered by nasogastric intubation once daily for 4 days. Both groups had no access to soil during the study period. The amounts of accumulated sand were evaluated radiographically before and after treatment. Significantly more treated horses cleared their sand accumulations than horses in the control group. This clearance was determined by observing the estimated quantity by area of sand remaining in the large colon (P < 0.001) and by comparing the numbers of successfully treated horses (P = 0.004) between the two groups after 4 days of treatment. However, there were unexplained individual variations in the clearance of sand accumulation.

Objectives: (3R)-Falcarinol (FaOH) and (3R,8S)-falcarindiol (FaDOH) have previously been shown to reduce the number of neoplastic lesions and the growth rate of polyps in the colon of azoxymethane (AOM) treated rats. Based on previous investigations, it appears that different mechanisms of actions are involved in the antineoplastic effect of FaOH and FaDOH. One mechanism of action may be related to the antibacterial effect of FaOH and FaDOH and thus their effect on the gut microbiota. This study aimed to determine the effect of FaOH and FaDOH on gut microbiota composition of AOM treated rats. Results: Azoxymethane treated rats were fed either a standard rat diet or a rat diet supplemented with FaOH and FaDOH. The gut microbiota of AOM-induced rats was determined by 16S rRNA gene-amplicon sequencing. Analysis of fecal cecum samples demonstrated a significant gut microbiota change in rats receiving standard rat diet supplemented with FaOH and FaDOH compared with the control group that only received the rat diet. Comparison of the gut microbiota of rats who developed large neoplasms in the colon with rats without large neoplasms showed that the gut microbiota was significantly different in rats who developed large colon neoplasms compared to rats with no macroscopic colon neoplasms.

Computed tomography (CT) was performed for an 18-year-old female pony with enterolithiasis in the prone and supine positions. CT images from the prone position revealed displacement of the large dorsal colon, which contained an enterolith to the ventral side of the abdomen, and those from the supine position revealed displacement to the dorsal side. A high-density material suggestive of a metallic foreign body was also observed in the enterolith core. An enterolith (422 g, 104 mm) was surgically removed from the large dorsal colon. This caused no complications after surgery and increased the horse’s weight. Changing positions during CT helps identify the exact location of enterolith and intestinal displacement due to enterolith weight, as well as size and number.

Summary A 22-year-old Thoroughbred mare presented to North Carolina State University Large Animal Hospital for evaluation of acute colic. After initial work-up, the mare was diagnosed and treated for presumed gas colic. She was subsequently further diagnosed and treated for gastric ulcers and mild sand accumulation in her large colon, based on gastroscopy and abdominal radiographs, respectively. The mare initially responded well to medical management of colic, but on Day 3 of hospitalisation, developed a low grade fever and signs of mild discomfort returned. Abdominocentesis at that time revealed an aseptic peritonitis and she was placed on antibiotics and NSAIDs. When no significant improvement was achieved, the mare was taken to surgery 2 days later. In surgery, she was diagnosed with nephrolithiasis of the left kidney that had erupted through the renal capsule and into the retroperitoneal space, as well as into the abdomen. Two nephroliths were found in the omentum. The mare was subjected to euthanasia due to a poor prognosis and submitted for necropsy, where 54 nephroliths were identified, associated with the left kidney. This report describes significant unilateral nephrolithiasis (to the point of renal rupture) in a horse with no azotaemia or other clinical signs of urinary tract disease.

Summary A one-day-old Thoroughbred colt foal was presented for assessment of abdominal pain and reduced urine output. Physical examination of the foal revealed marked abdominal distension, mild tachycardia, tachypnoea and congested mucous membranes. A marked anechoic peritoneal effusion, intestinal hypomotility and mural thickening of the large colon were detected sonographically. Serosanguinous fluid was obtained by abdominocentesis. After haemodynamic stabilisation, the foal underwent general anaesthesia and exploratory laparotomy and a 720° volvulus of the large colon at the sternal and diaphragmatic flexures was identified. After correction of the volvulus, the intraoperative findings were consistent with nonviability of the affected portion of the colon. The owner declined partial colon resection and elected for euthanasia of the foal. Although rare in neonatal foals, large colon volvulus should be considered in foals with signs of abdominal pain, abdominal distension and ultrasonographic findings of colonic mural thickening and luminal distension.

Objective To compare a 2-layer closure with suture line reversal for a pelvic flexure enterotomy to 1-layer and traditional 2-layer hand sewn closures. Study design Ex vivo, simple randomized study. Sample population Large colon segments from adult horses (n = 18). Methods Pelvic flexures were harvested from 18 horses and randomly assigned to 1 of 3 closure techniques (n = 6 per technique). A 10-cm enterotomy was made in each pelvic flexure and closed with the assigned technique. Closure time, luminal diameter via contrast radiographs, and bursting pressure were recorded for each specimen and compared between techniques using 1-way ANOVA with Duncan post hoc test at P

Wireless capsule endoscopes provide a painless and non-invasive alternative to the flexible endoscope in various applications of the gastrointestinal tract diagnosis. Operating a wireless capsule endoscope in the colon may benefit from an active position control as the large colon diameter can lead to uncontrollable and unpredictable capsule trajectory. Robot assisted magnetic steering is an attractive technique that is being explored by researchers worldwide. This paper presents the implications of a novel capsule geometry to markedly improve capsule stabilization and locomotion compared to the cylinder-based capsule geometry that is commonly used.

Equine colic is one of the most common cause of death in horses, but few studies have investigated specifically the conditions at the necropsy. This study aimed to describe the epidemiological and pathological features of noninfectious diseases of the gastrointestinal tract in horses. A retrospective study was conducted in search of cases of these diseases affecting horses from 2005 to 2017. During this period, 114 horses died of noninfectious diseases of the gastrointestinal tract, and the main causes were: primary gastric dilation (27/114), volvulus (27/114), enterolithiasis (20/114), rectal (colonic) perforation (15/114), gastric or cecocolonic impaction (10/114), incarcerations (6/114), intussusception (4/114), and others (5/114). Mixed breeds horses (56/114) and males (69/114) were mostly affected. The horses had a median and mean age of 10 and 10.9-years old, respectively. Primary gastric dilation was characterized by distension of the stomach by moderate to large amounts of content, which in 21 cases caused tearing of the stomach wall at the greater curvature (peritonitis), and the main predisposing factor was alimentary overload (17/27). Intestinal volvulus occurred within the small intestine (14 cases) and within the large intestines (13 cases). Grossly, there was intestinal ischemia with reddened to deep-black serosa and diffusely red mucosae. Enterolithiasis caused partial or complete obstruction of the right dorsal colon (9/20), transverse colon (4/20), small colon and right dorsal colon (3/20), rectum and right dorsal colon (2/20), and small colon (2/20). Viscera perforation and peritonitis occurred in 11 cases. Rectal (colonic) perforation involved the rectum (10/15), rectum/small colon (4/15), and the small colon (1/15). It was characterized by a focally extensive transmural tearing, associated with reddened borders, and retroperitoneal to diffuse peritonitis. Palpation related iatrogenic injuries (11/15) were the main cause. Impactions affected the large colon (7/10), the cecum (2/10), and the stomach (1/10). Incarcerations consisted of inguinoscrotal hernias (2/6), small intestine entrapment by a mesenteric failure (2/6), diaphragmatic hernia, and umbilical eventration. Grossly, the organs were constricted by a hernial ring, with intestinal ischemia and reddened to dark-red serosa. Predisposing factors included previous surgeries (2/6) and patent inguinal ring (1/6). Intussusception involved the small intestine (3/4) and ileocecum (1/4). Foals with lack of colostrum intake and concomitant pneumonia was a characteristic presentation (3/4). Grossly, the intussusceptum slipped into intussuscipiens, with diffuse deep black-red discoloration. Other causes included large colon displacement (2/5), extrinsic and intrinsic obstruction of the small intestine (2/5), and an intestinal adenocarcinoma. Noninfectious gastrointestinal diseases are major causes of death in horses. Epidemiological and gross features of the conditions should be accounted to obtain a final diagnosis of the cause of the colic. RESUMO: A cólica em equinos é considerada como a principal causa de morte de cavalos, porém poucos estudos têm investigado especificamente as condições envolvidas através da necropsia. O objetivo desse estudo foi descrever os aspectos epidemiológicos e patológicos de doenças não infecciosas do trato gastrointestinal de equinos. Foi conduzido um estudo retrospectivo em busca de casos dessas doenças envolvendo cavalos de 2005 a 2017. Durante esse período, 114 equinos morreram devido a doenças não infecciosas do trato gastrointestinal, e as principais causas foram: dilatação gástrica (27/114), vólvulos (27/114), enterolitíase (20/114), ruptura retal (colônica) (15/114), compactação gástrica ou cecocolônica (10/114), encarceramentos (6/114), intussuscepções (4/114), e outros (5/114). Animais sem raça definida (56/114) e machos (69/114) foram mais afetados. Os equinos apresentavam uma média e mediana de idade de 10 e 10,9 anos, respectivamente. A dilatação gástrica primária era caracterizada por distensão do estômago por moderada a grande quantidade de conteúdo, que em 21 casos provocava ruptura da parede gástrica na curvatura maior (peritonite), e o principal fator predisponente foi sobrecarga alimentar (17/27). Vólvulo intestinal ocorreu no intestino delgado e no intestino grosso (14 e 13 casos, respectivamente). Macroscopicamente, havia isquemia intestinal com serosa avermelhada a enegrecida e mucosa difusamente avermelhada. A enterolitíase causou obstrução parcial ou completa do cólon dorsal direito (9/20), cólon transverso (4/20), cólon menor e cólon dorsal direito (3/20), cólon menor (2/20), e reto e cólon maior direito (2/20). Perfuração de vísceras e peritonite foram observadas em 11 casos. A ruptura retal (colônica) envolveu o reto (10/15), reto/cólon menor (4/15) e cólon menor (1/15). Essa era caracterizada por ruptura transmural focalmente extensa, com bordos avermelhados e peritonite retroperitoneal a difusa. Traumas relacionados à palpação (11/15) foram a principal causa. Compactações afetaram o cólon maior (7/10), ceco (2/10) e estômago (1/10). Encarceramentos consistiram em hérnias inguinoescrotais (2/6), encarceramento de alças intestinais por falha no mesentério (2/6), hérnia diafragmática e eventração umbilical. Macroscopicamente, os órgãos estavam constritos por um anel hernial, com isquemia intestinal e serosa avermelhada a vermelho-escura. Fatores predisponentes incluíram cirurgias prévias (2/6) e anel inguinal patente (1/6). Intussuscepções envolveram o intestino delgado (3/4) e íleoceco (1/4). A apresentação característica foi em potros com falta de colostro e concomitante pneumonia. Macroscopicamente, o intussuscepto deslizava em direção ao intussuscepiente, exibindo coloração vermelho-enegrecida difusa. Outras causas incluíram deslocamento de cólon maior (2/5), obstrução extrínseca e intrínseca do intestino delgado (2/5), e um caso de adenocarcinoma intestinal. Doenças não infecciosas são importantes causas de morte em equinos. Os aspectos epidemiológicos e macroscópicos das condições devem ser considerados para o que o diagnóstico final da causa da cólica seja obtido.

Background Horses that undergo surgery for treatment of primary large colon disease have been reported to be at increased risk of developing recurrent colic episodes postoperatively. The reasons for this are currently unknown. The aim of the current study was to characterise the faecal microbiota of horses with colic signs associated with primary large colon lesions treated surgically and to compare the composition of their faecal microbiota to that of a control group of horses undergoing emergency orthopaedic treatment. Faecal samples were collected from horses in both groups on admission to hospital, during hospitalisation and following discharge from hospital for a total duration of 12 weeks. Additionally, colonic content samples were collected from surgical colic patients if pelvic flexure enterotomy was performed during laparotomy. A total of 12 samples were collected per horse. DNA was extracted from samples using a commercial kit. Amplicon mixtures were created by PCR amplification of the V1 – V2 regions of the bacterial 16S rRNA genes and submitted for sequencing using the Ion Torrent PGM next-generation sequencing system. Multivariate data analysis was used to characterise the faecal microbiota and to investigate differences between groups. Results Reduced species richness was evident in the colonic samples of the colic group compared to concurrent sampling of the faeces. Alpha and beta diversity differed significantly between the faecal and colonic microbiota with 304 significantly differentially abundant OTUs identified. Only 46 OTUs varied significantly between the colic and control group. There were no significant differences in alpha and beta diversity of faecal microbiota between colic and control horses at admission. However, this lack of significant differences between groups should be interpreted with caution due to a small sample size. Conclusions The results of the current study suggest that faecal samples collected at hospital admission in colic cases may not accurately represent changes in upper gut microbiota in horses with colic due to large colon disease.

Background: Colonoscopy is an invasive procedure used both diagnostically and therapeutically. Direct visualization and real-time image of entire large colon and distal terminal ileum makes it superior. Patients are unable to undergo colonoscopy because of the limitation in the developing country. Moreover, limited studies are available in our country regarding the colonic diseases. Materials and Methods: It was a descriptive cross-sectional study done in Nobel Medical College Teaching Hospital, Biratnagar, Nepal from January 2018 to December 2018. Approval was acquired from Institutional Review Committee. All patients undergoing colonoscopy in the hospital was included. After taking proper consent, bowel preparation, premedications, colonoscopy was performed, findings noted in pro-forma. Results: Of the total 176 patients 119 (67.60%) were male and 57 (32.40%) were female; mean age 46.98 ± 17.13 years. Indication for performing colonoscopy was chronic diarrhea in 58(33.0%), chronic abdominal pain in 47(26.70%). Significant lesion observed in 142 patients (80.68%); colitis with unspecified etiology in 69 (39.20%), ulcerative colitis in 28 (15.90%), crohn’s disease in 13(7.38%).Colitis was more in male 46(66.67%) and involving rectum was common. Pan-ulcerative colitis was common seen in 11patients (39.28%). Conclusion: Chronic diarrhoea and chronic abdominal pain were two common indications. Male patients were in higher prevalence opting for colonoscopy. Colitis of unspecified etiology of rectum and ileo-cecal region was most common finding. Ulcerative colitis involving whole of colon and younger age group was predominantly affected.

Primary gastrointestinal lymphoma is the most common type of extra-nodal lymphoma, representing about 30%-50% of all extra-nodal involvement. The stomach is the most common site, with the colon and rectum accounting for a minority of occurrences. Primary colorectal lymphoma is uncommon, representing only 0.3% of all large intestinal malignancies and approximately 3% of gastrointestinal (GI) lymphomas, with the majority of these being B-cell non-Hodgkin lymphoma and diffuse large B-cell lymphoma (DLBCL) being the most common subtype. We present a case of an 85-year-old male who presented with symptoms suggestive of bowel obstruction, who, after further evaluation, was diagnosed with primary non-Hodgkin lymphoma of the colon, DLBCL subtype.