Large Colon
Nonstrangulating Infarction
Basic Information 
Clinical Presentation
Disease Forms/Subtypes
• Verminous arteritis of the cranial mesenteric artery caused by S. vulgaris larval migration may present in acute or chronic forms.
• Conditions associated with systemic inflammatory response syndrome (SIRS) such as severe GI disease and sepsis may result in coagulopathies and thromboembolic disease that may present as nonstrangulating infarction of the large colon.
Physical Exam Findings
• Physical examination findings are variable depending on the cause of the nonstrangulating infarction, the degree of vascular compromise, and the amount of bowel affected.
• Variable tachycardia, tachypnea, and fever are associated with pain and endotoxemia.
• Other findings may include abdominal distension, decreased or absent borborygmi and alterations in fecal consistency and production.
• Endotoxemic shock may present with hyperemic or toxic mucous membranes, prolonged or decreased capillary refill time, poor pulse quality, cold extremities, and decreased jugular refill.
Etiology and Pathophysiology
• The pathophysiology of verminous arteritis is not well understood. Although some cases have obvious thrombosis, enlargement, aneurysm, or abscessation of the cranial mesenteric artery, other cases have no evidence of physical obstruction, and vasospasm has been proposed as the inciting cause of ischemia.
• Diseases associated with SIRS are frequently associated with coagulopathies caused by the procoagulant nature of many proinflammatory mediators. In horses with colitis, loss of antithrombin (a major anticoagulant protein) out of leaky vessels within the inflamed colon may also contribute to a procoagulant state.
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