Medical Versus Surgical Treatment of Ileal Impaction in Horses: Retrospective Evaluation of 245 Cases

1. Introduction
The most common site for intraluminal impaction of the small intestine in horses is the ileum. Although ileal impactions in horses have been treated successfully by both medical and surgical treatment, the decision to continue with aggressive medical therapy or yield to surgical intervention may be difficult. The objective of this study was to identify clinical parameters that would assist the clinician in determining the probability of a successful outcome with medical management versus the need for surgical intervention. Our hypothesis was that horses with ileal impaction that received aggressive medical therapy, did not produce significant amounts of nasogastric reflux, and were responsive to analgesic therapy would respond favorably to medical management, whereas horses with persistent abdominal pain and positive nasogastric reflux would require surgical intervention. [...]