Intra‐abdominal adhesions as a cause of cyclic pain, influenced by the stomach's filling state

Summary Recurrent colic in horses can result from a variety of causes, many of which remain undetected by standard diagnostic procedures. This case report describes a 21‐year‐old Tinker cross gelding presenting with intermittent colic episodes, for which conventional diagnostics, including rectal examination, ultrasound and blood work, failed to reveal a clear cause. Gastroscopy revealed severe squamous gastric ulcers (ESGD grade 4/4), and diagnostic laparoscopy identified a fibrous adhesion extending between the diaphragm and the greater curvature of the stomach, partially encircling it. This adhesion likely caused intermittent mechanical traction during gastric filling, resulting in pain and colic symptoms. The adhesion was successfully released via laparoscopic surgery, followed by medical management with omeprazole and sucralfate. Following the procedure, the gastric ulcers healed and the colic symptoms resolved. This case highlights the importance of using advanced diagnostic techniques, such as gastroscopy and laparoscopy, to identify complex causes of recurrent colic and guide effective treatment strategies. Identifying and addressing both the primary mechanical issue (adhesion) and its secondary effects (gastric ulcers) was key to the successful resolution of the colic episodes of this horse.