Small Intestine
Ileal Impaction
Basic Information 
Definition
Impaction of the distal-most segment of the small intestine (ileum) extending from the ileocecal papilla orally for varying lengths
Epidemiology
Associated Conditions and Disorders
Association between tapeworm infestation and ileal impactions has been made in the United States and Europe. These parasites attach to the intestinal mucosa at the ileocecal junction, causing mucosal inflammation, edema, and ulceration. Extent of injury is proportional to the number of parasites attached (>100 tapeworms)
S. vulgaris infestation may cause changes in motility and blood supply to the ileum. Uncommon because of current deworming practices.Clinical Presentation
History, Chief Complaint
Clinical signs are consistent with abdominal discomfort or colic. Early in the disease, pain is caused by spasmodic contraction of the ileum around the impaction. Systemic compromise is not seen at this stage. As the disease progresses, signs of colic worsen caused by the progressive distension of the small intestine with gas and sequestered fluids. Systemic signs of dehydration also start to appear. If not treated, intestinal or gastric rupture may occur. Important historical information usually includes an abrupt change in feeding practices, such as
Etiology and Pathophysiology
• Abrupt change in feeding practices, particularly to CBH from other grass hay or legume hay. Lignin and crude fiber content increases as hay matures as with tall stands or in late summer and early fall.
• Tapeworm infestation causes mucosal injury, resulting in changes in intestinal motility and reduction in size of the ileocecal papilla.
• Ileal hypertrophy causes changes in intestinal motility and variable reduction in size of the ileal lumen.
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