Idiopathic focal eosinophilic enteritis associated with ileocaecal and ileal obstruction in a 10-year-old warmblood gelding

Abstract

A 10-year-old, 600-kg, warmblood gelding was referred due to persistent colic, non-responsive to medical treatment. Diagnostic evaluation revealed abdominal distention, tachycardia and distended small intestines. Preoperative blood testing revealed an increased packed cell volume and normal total white cell count, whereas an abdominocentesis revealed raised peritoneal fluid lactate. Exploratory laparotomy was performed and revealed a circumferential band of thickened tissue and hyperaemia in the distal jejunum, as well as marked wall thickening of the distal ileum and ileocaecal valve, leading to complete luminal obstruction. Due to financial constraints and complications associated with jejuno-caecostomy, the owner requested the horse to be humanely euthanased. Postmortem examination findings revealed a circumferential constriction of the distal ileum and ileocaecal valve. Histopathology of the affected segments was characterised by a large population of eosinophils within the mucosa, submucosa and muscularis layers in conjunction with severe submucosal oedema. A diagnosis of idiopathic focal eosinophilic enteritis was made.