Sand Impaction

Sand Impaction



Basic Information image



Definition


Accumulation of sand or gravel within the intestine producing irritation and potentially obstructing the flow of ingesta or gas



Synonym(s)


Sand accumulation, sand colic, sand colitis



Epidemiology



Species, Age, Sex


Most common in horses older than 1 year, but reported in horses of all ages, including foals



Genetics and Breed Predisposition


Some suggest that Miniature horses are predisposed.



Risk Factors


Reported risk factors include inadequate access to roughage and access to sand or mineral composition of the soil.



Geography and Seasonality


Regions with sandy soil such as California, Florida, Michigan, and coastal U.S. states have increased incidence.



Associated Conditions and Disorders


Sand impaction has been reported in combination with large colon displacements and volvulus (25%–54%). It has been suggested that this is a result of a change in motility associated with sand accumulation.



Clinical Presentation



History, Chief Complaint


Clinical signs of sand impaction are variable depending on the degree of inflammation and obstruction. Owners may report signs of colic, diarrhea, and weight loss.



Physical Exam Findings




• Horses with sand impaction have similar physical examination findings to horses with other simple obstructions of the large colon (see “Large Colon: Impaction” in this section) or large colon displacements (see “Large Colon: Left Dorsal Displacements” and “Large Colon: Other Displacements” in this section) or volvulus (see “Large Colon: Volvulus” in this section) if present in combination.


• In addition, horses with sand impactions may show variable signs of endotoxemia and inflammation associated with irritation and compromise of the mucosa. Elevations in temperature, heart rate, and respiratory rate and changes in mucous membrane color and capillary refill time are consistent with endotoxemia.



Etiology and Pathophysiology




• Sand accumulation can result in irritation or inflammation of the mucosa, obstruction of the flow of ingesta, and alterations in motility.


• The most common sites for sand impaction are the right dorsal colon followed by the transverse colon followed by the left dorsal colon. However, impaction can occur throughout the large colon and in the small colon and ileocecal junction as well.



Diagnosis image



Differential Diagnosis




• Other causes of mild to moderate abdominal pain: Simple or nonstrangulating obstructions of the gastrointestinal tract such as large colon impactions (feed), large colon displacements, large intestinal intraluminal obstructions, tympany, small colon impactions, and ileal impactions (see respective entries in this section).


• Other causes of large intestinal distension on examination per rectum: Large colon impactions (feed), tympany, large colon displacements, and other intraluminal obstructions (see respective entries in this section).


• Other causes of diarrhea and weight loss: Chronic salmonellosis, parasitism, and inflammatory bowel disease.

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Jul 24, 2016 | Posted by in SMALL ANIMAL | Comments Off on Sand Impaction

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