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Vetdle Archive

Archive Case #204: Equine Nephrosplenic Entrapment

Horse veterinary case - Medium - September 23, 2026

Clinical Clues

  1. Atlas, an adult gelding, leaves his breakfast, paws the ground and repeatedly looks towards his flank.
  2. He has passed fewer droppings than usual, and his abdominal discomfort comes and goes.
  3. Rectal examination finds gas-distended large colon displaced towards the left side of the abdomen.
  4. Ultrasound shows gas-filled bowel medial to the spleen, obscuring the usual view of the left kidney.
  5. The rectal examination identifies large colon crossing above the ligament connecting the spleen to the left kidney.
  6. The findings localise the colon to the nephrosplenic space, trapped over that ligament: a specific left dorsal displacement.

Diagnosis

Equine Nephrosplenic Entrapment

The abnormal anatomical position identifies nephrosplenic entrapment. Failure to see the kidney on ultrasound raises suspicion; the corresponding rectal findings strengthen the diagnosis. Colic describes Atlas’s pain, but not the lesion causing it. Remember: For displacement cases, identify where the bowel has moved—not just how painful the horse appears.

Learning review

Review the case evidence

Use the paired clues to explain how the evidence in this horse case supports the provided diagnosis, Equine Nephrosplenic Entrapment, then compare your reasoning with the case explanation.

Evidence checkpoints

Clues 1-2

  1. Clue 1: Atlas, an adult gelding, leaves his breakfast, paws the ground and repeatedly looks towards his flank.
  2. Clue 2: He has passed fewer droppings than usual, and his abdominal discomfort comes and goes.

Clues 3-4

  1. Clue 3: Rectal examination finds gas-distended large colon displaced towards the left side of the abdomen.
  2. Clue 4: Ultrasound shows gas-filled bowel medial to the spleen, obscuring the usual view of the left kidney.

Clues 5-6

  1. Clue 5: The rectal examination identifies large colon crossing above the ligament connecting the spleen to the left kidney.
  2. Clue 6: The findings localise the colon to the nephrosplenic space, trapped over that ligament: a specific left dorsal displacement.

Self-review prompts

  1. After clues 1-2, what evidence from this horse case shaped your initial interpretation?
  2. When you compare clues 3-4 with clues 1-2, what changed in your reasoning about Equine Nephrosplenic Entrapment?
  3. How do clues 5-6 align with the case explanation for Equine Nephrosplenic Entrapment?

Educational Use

Vetdle archive cases are educational veterinary games for diagnostic reasoning practice. They do not provide veterinary advice, diagnosis, treatment, or professional medical guidance.