Closing the epiploic foramen: Why and how?

Small intestinal strangulating lesions including epiploic foramen entrapment (EFE) are serious life-threatening conditions. In about 5% of surgically treated equine colic patients, colic signs are the result of intestinal EFE. Archer et al [1] described several risk factors for the development of EFE with windsucking/crib-biting being the most important ones. Recurrence of EFE has been reported to vary between 2 and 14%. Recent work has demonstrated the funnel-like shape of the omental vestibule with two openings: a smaller one on the right side of the median plane, which is the EF and a large one on the left side, which is the opening from the omental vestibule to the caudal recess of the omental bursa [2,3]. This funnel like configuration could explain the predominant left to right intestinal incarceration as encountered in clinical practice. The reported increased intra-abdominal pressure during cribbing [4] has been suggested as causative factor for intestinal EFE at the level of the EF ...