Laparoscopic ablation of the nephrosplenic space in a seven year old Quarter Horse gelding

Dusty, a seven year old Quarter Horse gelding, presented to Cornell University’s Large Animal Emergency Service in June 2009 for evaluation of a colic that had not responded to treatment in the field. Physical examination abnormalities included: tachycardia, tachypnea, dehydration, absent gastrointestinal sounds bilaterally, and visible signs of abdominal pain (pawing, trembling, etc). Further evaluation via rectal palpation, transabdominal ultrasonography, and passage of a nasogastric tube revealed palpably firm large colon in the left abdomen with gas distension palpable cranially, thickened large intestinal wall in the left abdomen, and no gastric reflux, respectively. Preliminary blood work and peritoneal fluid analysis indicated an elevated peripheral and peritoneal lactate. Due to uncontrollable pain exploratory celiotomy was performed and left dorsal displacement of the large colon (nephrosplenic entrapment) was diagnosed at the time of surgery. This was the second nephrosplenic entrapment within 8 months, so standing laparoscopic ablation of the nephrosplenic space was elected as a preventative measure against future nephrosplenic entrapment. The ablation of the nephrosplenic space was performed 2 days after the exploratory celiotomy; Dusty recovered well and as of October 1, 2009 had not shown any further evidence of colic