NAVLE Gastrointestinal and Digestive

Equine Duodenitis-Proximal Jejunitis Study Guide

Duodenitis-proximal jejunitis (DPJ), also known as anterior enteritis or proximal enteritis, is an acute inflammatory condition of the proximal small intestine (duodenum and proximal jejunum) characterized by ileus, massive nasogastric reflux, and...

Overview and Clinical Importance

Duodenitis-proximal jejunitis (DPJ), also known as anterior enteritis or proximal enteritis, is an acute inflammatory condition of the proximal small intestine (duodenum and proximal jejunum) characterized by ileus, massive nasogastric reflux, and systemic signs of toxemia. This condition is frequently tested on the NAVLE due to its clinical importance, diagnostic challenges, and potential for life-threatening complications.

DPJ occurs sporadically in horses and can be difficult to differentiate from surgical conditions such as small intestinal strangulation or obstruction. Understanding the pathophysiology, clinical presentation, and appropriate management is essential for equine practitioners and critical for board examination success.

Agent Evidence Level Key Points
Clostridium difficile STRONGEST - Experimental reproduction achieved Toxins A and B cause epithelial damage; isolated from 10/10 DPJ cases in one study; experimental toxin administration reproduced disease
Clostridium perfringens Moderate - Association reported Type D predominant in DPJ cases; alpha and epsilon toxins may cause damage; isolated from 70% of cases in one study
Salmonella spp. Weak - Anecdotal reports Limited evidence; experimental inoculation did not reproduce DPJ; likely not a primary cause
Mycotoxins (Fumonisins) Weak - Single study High doses caused duodenal/jejunal inflammation but not classic DPJ; may play contributory role

Terminology and Synonyms

This condition has multiple names in the literature, which may appear on board examinations:

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