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1.
Surgical diseases of the equine cecum   总被引:1,自引:0,他引:1  
Cecal impaction and cecal perforation, the two most common equine cecal diseases, are thought to develop after slowing or interruption of a single progressive motility pattern, which begins in a pacemaker area near the apex, occurs once every 3 minutes, and propels ingesta from the cecum to the right ventral colon. Rectal examination in horses with cecal impaction is the most useful technique to grade the severity of the condition. Medical treatment is undertaken if the impaction is judged to be mild to moderate. Surgical correction of cecal impaction in severe cases requires a ventral midline celiotomy, and exploration reveals a large ingesta-filled cecum and relatively empty large colon. Currently, the techniques of typhlotomy with manual evacuation of ingesta, combined with a complete bypass of the cecum by use of a jejunocolostomy, is the preferred method of surgical management. The use of a cecocolic anastomosis remains a viable alternative surgical procedure. Cecal perforation (CP), a uniformly fatal disease of horses, most often develops when the subtle signs of cecal impaction are missed or are masked by the administration of nonsteroidal antiinflammatory agents. CP can occur in mares around the time of foaling and, in this form, is not associated with cecal outflow dysfunction. Surgical management of cecocecal or cecocolic intussusception is required and involves resection of the diseased portion of cecum, either with extra- or intraluminal techniques. Both the side-to-side and end-to-side jejunocecal anastomoses are useful and successful techniques for bypass of simple or strangulating lesions of the ileum.  相似文献   

2.
OBJECTIVE: To report the postoperative outcome in horses undergoing jejunoileal anastomosis performed with a 2-layer simple continuous technique. DESIGN: Retrospective study. ANIMALS: 7 horses. PROCEDURE: Information regarding signalment, clinical signs, findings at surgery, and postoperative complications was obtained from medical records of horses that underwent exploratory ventral midline celiotomy, small intestinal resection, and jejunoileal anastomosis to correct various small intestinal strangulating lesions. Follow-up information was obtained via telephone conversations with owners or trainers. RESULTS: Six males and 1 female of various breeds aged 10 months to 27 years and weighing 312 to 785 kg (686.4 to 1,727 lb) were included. The most common complications were mild to moderate tachycardia and mild to moderate signs of abdominal pain. Two horses developed incisional infections and soft, fluctuant swelling at the incision site following resolution of the infection. Follow-up time ranged from 7 to 17 months after surgery. Owners reported no further colic episodes and no diet change necessary following surgery. All horses had returned to their intended level of use. CONCLUSIONS AND CLINICAL RELEVANCE: Advantages to the jejunoileal technique include maintaining the normal ileocecal valve and a postoperative recovery period similar to that described following other small intestinal anastomoses. Jejunoileal anastomosis is a viable alternative to ileal bypass. This technique appears to result in a postoperative complication rate similar to that reported following jejunojejunostomy procedures.  相似文献   

3.
OBJECTIVE: To determine if morphologic evaluation of intraoperative biopsies of the large colon could be used to accurately predict outcome in horses with large colon torsion. STUDY DESIGN: Clinical study. ANIMALS: Fifty-four horses with large colon torsion. METHODS: A full-thickness biopsy was collected from the pelvic flexure of the ascending colon after correction of naturally occurring colonic torsion. Morphologic changes were evaluated and graded for interstitial tissue to crypt ratio (I:C ratio), percentage loss of superficial and glandular epithelium, and the degree of hemorrhage and edema. These variables were then used to predict survival. RESULTS: Morphologic variables could be used to correctly predict survival or death in 51 horses (P < .0001). This corresponded to a sensitivity of 95.1% (82.2%-99.2%; 95% CI) and a specificity of 92.3% (62.0%-99.6%; 95% CI). Of 6 horses that had colonic resection, 5 survived; an accurate prediction of outcome based on morphologic criteria was made for each horse. CONCLUSIONS: Interpretation of changes in colonic morphology can be used to accurately predict postoperative survival in horses with large colon torsion. CLINICAL RELEVANCE: Use of frozen colonic tissue sections is a rapid, reliable, and relatively inexpensive method for assessing morphologic damage associated with large colon torsion during surgery. Intraoperative evaluation of pelvic flexure biopsies can aid in the prediction of survival and guide surgical judgment as to the need for colonic resection.  相似文献   

4.
OBJECTIVE: To determine whether infection with Tritrichomonas foetus causes diarrhea in specific-pathogen-free or Cryptosporidium coinfected cats. ANIMALS: 4 cats with subclinical cryptosporidiosis (group 1) and 4 specific-pathogen-free cats (group 2). PROCEDURE: Cats were infected orogastrically with an axenic culture of T. foetus isolated from a kitten with diarrhea. Direct microscopy and protozoal culture of feces, fecal character, serial colonic mucosal biopsy specimens, and response to treatment with nitazoxanide (NTZ; group 1) or prednisolone (groups 1 and 2) were assessed. RESULTS: Infection with T. foetus persisted in all cats for the entire 203-day study and resulted in diarrhea that resolved after 7 weeks. Group-1 cats had an earlier onset, more severe diarrhea, and increased number of trichomonads on direct fecal examination, compared with group-2 cats. Use of NTZ eliminated shedding of T. foetus and Cryptosporidium oocysts, but diarrhea consisting of trichomonad-containing feces recurred when treatment was discontinued. Prednisolone did not have an effect on infection with T. foetus but resulted in reappearance of Cryptosporidium oocysts in the feces of 2 of 4 cats. During necropsy, T. foetus was isolated from contents of the ileum, cecum, and colon. Tritrichomonas foetus organisms and antigen were detected on surface epithelia and within superficial detritus of the cecal and colonic mucosa. CONCLUSIONS AND CLINICAL RELEVANCE: After experimental inoculation in cats, T. foetus organisms colonize the ileum, cecum, and colon, reside in close contact with the epithelium, and are associated with transient diarrhea that is exacerbated by coexisting cryptosporidiosis but not treatment with prednisolone.  相似文献   

5.
CASE DESCRIPTION: 3 horses were evaluated for signs of colic; cecocolic intussusception was detected. CLINICAL FINDINGS: Abnormalities detected included diminished intestinal sounds, inflammatory leukogram, dehydration, unremarkable fi ndings via rectal palpation, and ultrasonographic evidence of large intestine intussusception. Laparotomy revealed cecocolic intussusception. TREATMENT AND OUTCOME: Cecal bypass via side-to-side ileocolic anastomosis without ileal transection was performed in each horse by use of an intraluminal anastomosis stapler device. Postoperative complications were minimal, and all horses recovered rapidly and were clinically normal at > 12 months after surgery. CLINICAL RELEVANCE: Cecal bypass via side-to-side ileocolic anastomosis without ileal transection seemed to offer 2 potential advantages over traditional surgical techniques for treating this condition. The risk of abdominal contamination was far less than with techniques in which the colotomy is needed to enable resection of the cecum or techniques in which the ileum is transected. Also, it was technically simpler to perform because there was no need to transect the ileum, oversew the ileal stump, perform cecal resection, or close the mesenteric space created by relocating the jejunal stump to the right ventral colon.  相似文献   

6.
OBJECTIVE: To assess a laparoscopic technique for equine intestinal biopsy. STUDY DESIGN: Experimental study. ANIMALS: Seven adult horses. METHODS: Food but not water was withheld for 36 hours before laparoscopy. In 3 horses (group A) standing, right laparoscopic access to different small intestinal segments was compared with ventral median celiotomy access. Inaccessible segments were identified at necropsy. In 4 horses (group B), the feasibility of obtaining full-thickness duodenal and cecal biopsies and any associated morbidity were evaluated. Biopsy specimens were collected during standing right laparoscopy using a 2-step procedure and intracorporeal suturing technique, and abdominal lavage was performed. Horses were monitored clinically and by abdominal fluid cytology and microbial culture, and repeat laparoscopy was performed on day 6. RESULTS: Standing right flank laparoscopy provided good observation of small intestinal segments and enabled manipulation of all but 15-20 cm of the duodenum and approximately 40 cm more ileum compared with ventral median celiotomy. Group B horses had no complications, no adhesions, and no bacterial growth from peritoneal fluid samples. None of the horses had signs of abdominal pain. CONCLUSION: A 2-stage intestinal biopsy technique performed during standing, right flank laparoscopy may be a safe alternative to exploratory celiotomy and biopsy in normal horses. CLINICAL RELEVANCE: Right flank laparoscopy allows biopsy of intestinal segments including duodenum and 50% more of the ileum than is accessible by ventral median celiotomy. This technique should be evaluated in clinical patients.  相似文献   

7.
OBJECTIVE: To evaluate whether changes in myoelectrical activity in the cecum and large colon of horses can be detected via multichannel electrointestinography (EIG). ANIMALS: 6 healthy mature horses. PROCEDURES: Each horse underwent 3 EIG procedures. Intestinal myoelectrical activity (cecum and large colon) was recorded during a 20-minute period following i.v. administration of physiologic saline (0.9% NaCl) solution (20 mL; baseline), erythromycin lactobionate (0.5 mg/kg), or detomidine (0.015 mg/kg); intestinal contractions were concurrently viewed via B-mode ultrasonography. By use of computer software, 8-channel EIG recordings were analyzed and the mean of the dominant frequency (a measure of the rhythmicity of gastric electrical activity) expressed in cycles per minute (cpm) was obtained. Total power (muV(2)) was calculated, and treatment effect was expressed as the power ratio (ie, treatment-associated power divided by the baseline power). RESULTS: The dominant frequency cpm values were not stable, and no significant differences between treatments were detected. Compared with the effects of saline solution treatment, detomidine significantly reduced the mean cecal and colonic power ratios. Erythromycin significantly reduced the cecal power ratio and increased the colonic power ratio, although the increase was significant in only 1 channel. Ultrasonographic findings and total power (predominantly from the long-distance electrode pairs) were significantly correlated. CONCLUSIONS AND CLINICAL RELEVANCE: In horses, EIG was useful for assessment of changes in myoelectrical activity in the cecum and large colon. Multiple electrodes should be used to cover a larger area of the intestine, and agreement between multiple channels is needed to make the analysis meaningful.  相似文献   

8.
Laparoscopic repair of a small intestinal mesenteric rent in a broodmare   总被引:1,自引:0,他引:1  
OBJECTIVES : To describe standing laparoscopic repair of mesoduodenal rent inaccessible by ventral median celiotomy. STUDY DESIGN : Clinical case report. SAMPLE POPULATION : A 6-year-old Thoroughbred broodmare with a right displacement of the dorsal colon and small intestinal incarceration in a mesoduodenal rent. METHODS : Two days after correction of a right dorsal displacement of the ascending colon, small intestinal incarceration, and partial closure of mesoduodenal rent, standing left and right flank laparoscopy was used to explore the abdomen to identify the mesoduodenal defect. The mesenteric rent was repaired from right flank portals by approximation with hemostatic clips. RESULTS : Approximation of the mesoduodenal rent was achieved with laparoscopic clips. No further complications or signs of abdominal pain occurred over the following year. CONCLUSIONS : Mesenteric rents in the mesoduodenum can be repaired by laparoscopic techniques in the standing horse. CLINICAL RELEVANCE : Use of laparoscopic techniques in the standing horse should be considered for mesoduodenal rents that are not accessible form a ventral median celiotomy.  相似文献   

9.
Colonic torsion is a life‐threatening condition that results in colonic ischemia, necrosis, perforation, sepsis, and eventual death. The aim of this multicenter, retrospective case series study was to describe the CT findings in dogs with surgically confirmed colonic torsion. Medical records were searched for dogs with surgically confirmed colonic torsion following abdominal CT. Five dogs met the inclusion criteria. Three had a history of chronic intermittent diarrhea prior to presentation. Two dogs presented with acute vomiting, diarrhea, and abdominal pain and one dog presented with acute vomiting and lethargy. Computed tomographic findings in all dogs with surgically confirmed colonic torsion include: “whirl sign,” displacement and distension of the cecum and colon, focal narrowing of the colon, and distension of the mesenteric vasculature in all dogs (5/5); streaky peritoneal fat and peritoneal effusion (4/5), pneumatosis coli (2/5), small intestinal distension (2/5), portal vein thrombosis (1/5), and reduced colonic wall contrast enhancement (1/5). In all dogs (5/5), the torsion site was the descending colon and demonstrated an anticlockwise rotation. At surgery, three of the five dogs had a partial colonic torsion with hyperemia at the site of obstruction and two of the five dogs had a complete torsion with marked necrosis of the colonic wall. Displacement of the colon and cecum, segmental distension and focal narrowing of the colon, the presence of a “whirl sign” and distension of the mesenteric vasculature are CT findings highly suggestive of colonic torsion.  相似文献   

10.
An acute intestinal obstruction caused by a torsion of the descending colon with incarceration and strangulation of the apex of the cecum was diagnosed in a mature Holstein cow. The clinical signs manifested were acute anorexia, depression, signs of abdominal pain, and absence of feces. Rectal examination revealed a sharp decrease in luminal size of the descending colon and taut bands at that level. The final diagnosis was obtained by exploratory celiotomy. Although surgical correction was attempted, the cow died of acute fecal peritonitis 18 hours postoperatively.

Acute intestinal obstruction caused by torsion of the descending colon in the cow has not been reported in the literature.

  相似文献   

11.
Obstruction of the spiral loop of the ascending colon (spiral colon) due to adhesions causing extraluminal constriction was diagnosed in 8 cows during a 2-year period. The adhesions resulted from intraperitoneal injections in 7 cows and from previous intra-abdominal surgery in the 8th. Surgical correction was performed in 4 of the cows by uniting the bowel proximal and distal to the obstruction, thus creating an intestinal bypass. Approximately half of the large intestine was bypassed in this manner in 3 cows; all but a portion of the descending colon and rectum was bypassed in the 4th. Each of the cows survived surgery, although 1 died 30 days later, possibly as a result of a second obstruction caused by further adhesions. Appetite, general physical condition, and milk production returned after celiotomy and intestinal bypass. Feces were loose after operation but gradually firmed to near-normal consistency in 3 of the cows.  相似文献   

12.
CASE HISTORY: Torsion of the descending colon was diagnosed by barium enema radiography in an adult Irish Water Spaniel which had presented with tenesmus of 24 h duration. Treatment involved exploratory laparotomy, repositioning of the colon, colopexy and repair of a mesenteric rent. No definitive cause of the torsion could be established. The dog made an uneventful recovery from surgery. CLINICAL RELEVANCE: Animals presenting with constipation of undetermined cause should have large intestinal obstruction ruled out prior to administering bowel cleansing solutions per os and/or colonic enemas. Colonic obstruction by torsion should be considered as a possible differential diagnosis in all cases of tenesmus.  相似文献   

13.
A mixed‐breed dog presented with tenesmus, hematochezia, and abdominal distension of 2 weeks duration. Radiography showed a large round mass with a “soap‐bubble” appearance and shell‐like mineralization in the caudal abdomen. Computed tomography revealed a lamellate mineralized mass 8 cm in diameter and containing air in the descending colon and prostatic abscess. Heterogeneously contrast‐enhanced, irregularly thickened colonic wall with intramural and peritoneal free gas indicated stercoral colonic perforation. Surgical intervention revealed a tumor‐like giant fecaloma in the descending colon adjoining the prostate with extensive wall rupture and fecal peritonitis. Hypothetically, prostatic inflammation may affect colonic motility with resultant fecaloma formation.  相似文献   

14.
本试验旨在研究日粮中添加复合维生素B对生长期山羊消化道微生物组成和肠黏膜结构的影响。试验选取10只4月龄波杂雌山羊(12.60±1.28) kg,随机分为对照组(control,CON)和复合维生素B处理组(vitamin B,VB),CON组饲喂基础日粮(n=5),VB组在基础日粮中添加复合维生素B(n=5),预饲期2周,试验期11周,试验期间自由饮水。试验结束后屠宰采样,16S rRNA测序分析盲肠和结肠内容物微生物组成,检测肠道上皮组织形态结构和相关基因与蛋白的表达。通过菌群分类学分析发现,与CON相比,VB组山羊盲肠和结肠内容物菌群的α多样性指数无显著变化(P>0.05);在门水平上,盲肠和结肠内容物菌群中厚壁菌门(Firmicutes)和拟杆菌门(Bacteroidetes)为优势菌门,VB组盲肠拟杆菌门丰度有升高趋势(0.05<P<0.1),而螺旋菌门(Spirochaetes)丰度有降低趋势(0.05<P<0.1);在目水平上,VB组盲肠Solirubrobacterales和Streptomycetales目菌群丰度显著下降(P<0.05);在科水平上,VB组盲肠Christensenellaceae、Streptomycetaceae、Solirubrobacteraceae及结肠Christensenellaceae科菌群丰度显著下降(P<0.05);在属水平上,VB组盲肠Lachnoclostridium属菌群丰度显著升高(P<0.05),盲肠BacillusNocardioides及结肠unidentified_Christensenellaceaeunidentified_Gammaproteobacteria属菌群丰度显著下降(P<0.05)。与CON相比,VB组山羊空肠绒毛高度(P<0.01)、隐窝深度(P<0.05)和绒毛高度/隐窝深度(V/C,P<0.05)均显著增加;回肠隐窝深度显著降低(P<0.05),绒毛高度和V/C无显著变化(P>0.05)。实时荧光定量PCR结果显示,与CON相比,VB 组山羊盲肠上皮紧密连接和细胞增殖相关基因的表达均无显著变化(P>0.05);而结肠黏膜上皮OccludinP<0.05)、EGFRP<0.01)、MIK67P<0.05)和CCNDP<0.05)基因表达均显著上调;且VB组ZO-1蛋白表达显著上调(P<0.05)。综上表明,日粮中添加复合维生素B对生长期山羊肠道菌群多样性无显著影响,但可提高肠道中有益菌的丰度且降低有害菌的丰度,从而促进肠道绒毛的生长及紧密连接蛋白的表达,对山羊肠道健康和生长具有积极作用。  相似文献   

15.
CASE HISTORY: Torsion of the descending colon was diagnosed by barium enema radiography in an adult Irish Water Spaniel which had presented with tenesmus of 24 h duration. Treatment involved exploratory laparotomy, repositioning of the colon, colopexy and repair of a mesenteric rent. No definitive cause of the torsion could be established. The dog made an uneventful recovery from surgery.

CLINICAL RELEVANCE: Animals presenting with constipation of undetermined cause should have large intestinal obstruction ruled out prior to administering bowel cleansing solutions per os and/or colonic enemas. Colonic obstruction by torsion should be considered as a possible differential diagnosis in all cases of tenesmus.  相似文献   

16.
CASE DESCRIPTION: 6 dogs and a cat were evaluated because of caudal colonic and rectal masses. CLINICAL FINDINGS: Tumors were identified in the caudal portion of the colon (n = 2), in the area of the colorectal junction (2), or in the rectum (3). TREATMENT AND OUTCOME: In all 7 animals, bilateral pubic and ischial osteotomy was performed to provide exposure of the rectum and associated tumor. Masses were successfully removed, and all 7 animals were able to ambulate normally within 3 days after surgery. No complications associated with the osteotomy procedure were identified. CLINICAL RELEVANCE: Findings suggested that bilateral pubic and ischial osteotomy provided sufficient exposure for resection of intrapelvic tumors in dogs and a cat with minimal complications.  相似文献   

17.
OBJECTIVE: To report our experience with horses that presumptively had severe intraluminal hemorrhage from enterotomy or anastomosis. STUDY DESIGN: Clinical study. ANIMALS: Six adult horses and 1 adult donkey. METHODS: A retrospective study was conducted at the University of Illinois (April 1994 to December 2001) to determine the clinical course and outcome of horses with melena and/or anemia and evidence of life-threatening hemorrhage from intestinal incisions. Medical records of all horses that had colic surgery were reviewed to determine the proportion of horses with this complication. In addition, horses that fit the same criteria identified in 3 other veterinary clinics were included. RESULTS: Three horses (1.3%) of those that had enterotomy or anastomosis at the University of Illinois and 4 horses from other clinics had complications presumptively related to severe hemorrhage from these intestinal procedures. Melena became evident within 72 hours of surgery and lasted 12 to 96 hours. Six horses had an acute and severe drop in packed cell volume (PCV), increased heart rates, and other signs of acute hemorrhage, and 1 horse had signs of colic postoperatively. Horses were administered intravenous formalin (3 horses) and whole blood transfusions (4 horses). Repeat celiotomy was performed on 2 horses. In 1 of these horses, a bleeding artery was ligated in the edge of the original enterotomy, and, in the other, a 25-cm-diameter intraluminal blood clot was found occluding the pelvic flexure. A horse that had jejunocolostomy for cecal impaction was not treated for hemorrhagic shock but was euthanatized and necropsied. Necropsy revealed blood-filled bowel from the jejunocolostomy to the anus. One of the remaining 6 horses died of enterocolitis and 5 survived to discharge. CONCLUSIONS: Hemorrhage from incisional edges, particularly in the large intestine, should be considered a rare but possibly fatal complication of enterotomy or anastomosis in horses. CLINICAL RELEVANCE: To prevent fatal hemorrhage from incisional edges during enterotomy or anastomosis, large vessels should be ligated at the original surgery, and hemostatic effects of different closure techniques should be considered. No intraoperative or postoperative findings were useful to predict this complication, and response to supportive medical therapy was favorable.  相似文献   

18.
A 7-month-old sexually intact female Vietnamese pot-bellied pig was evaluated because of constipation. On abdominal palpation, a hard tubular structure was palpated in the middle of the abdomen. Abdominal radiography revealed loops of intestine that were markedly distended with ingesta, consistent with obstructive intestinal disease. On exploratory celiotomy, a massively distended cecum and spiral colon were found. A subtotal colectomy, with a side-to-side ileocolonic anastomosis, was performed. The cause of the megacolon was not discovered. The pig did well following surgery and eventually defecated normally following an initial period of diarrhea. To our knowledge, this is the first report of therapeutic removal of a substantial portion of the large intestine in swine. Our decisions concerning the pig of this report were based largely on our knowledge of megacolon in cats. The outcome for this pig indicates that subtotal colectomy along with removal of the cecum and ileocecal valve can be used to successfully treat idiopathic megacolon in Vietnamese pot-bellied pigs.  相似文献   

19.
OBJECTIVE: To determine clinical and surgical abnormalities in, and long-term outcome of, horses that undergo surgery because of colic secondary to inflammatory bowel disease (IBD). DESIGN: Retrospective study. ANIMALS: 11 horses. PROCEDURE: Medical records of horses that had undergone abdominal surgery and in which IBD had been diagnosed on the basis of histologic examination of intestinal biopsy specimens were reviewed. RESULTS: 5 horses were examined because of acute colic and 6 were examined because of chronic colic. At surgery, all 11 horses had edematous or hemorrhagic bowel segments suggestive of IBD. In addition, 6 horses had circumferential mural bands (CMB) causing constriction of the small (4 horses) or large (2) intestine. Intestinal resections were performed in 7 horses. All 11 horses survived surgery and were discharged from the hospital; 10 horses were still alive at the time of follow-up (1.5 to 7 years after surgery). CLINICAL IMPLICATIONS: Results suggest that IBD is an uncommon cause of colic in horses. Surgical resection of segments of intestine with constrictive CMB may relieve clinical signs of colic. Horses with IBD that had surgery had a good prognosis for long-term survival.  相似文献   

20.
Colonic torsion is a life‐threatening condition in dogs and radiographic findings for this condition have not been well described. The purpose of this retrospective case series was to describe radiographic findings and clinical signs in a group of dogs with colonic torsion. Inclusion criteria were dogs presenting during the period of 2006 and 2016, and that had abdominal radiography and a surgically confirmed or presumed diagnosis of colonic torsion. For each dog, clinical data were recorded from medical records and imaging findings were recorded from retrieved plain radiographs and positive contrast radiographs in which barium enema was performed. Fourteen dogs met inclusion criteria. Of these, nine dogs had colonic torsion confirmed at surgery, with five dogs having surgical confirmation of colonic congestion or mesenteric torsion. Radiographic findings included segmental distention of the colon (14/14), focal narrowing of the colon (11/14), displacement of cecum (11/14), displacement of descending colon (14/14), and mild to no small intestinal distention (14/14). In cases where barium enema was performed, focal narrowing of the colon and longitudinal striations that course in a helical pattern were identified, termed the “torsion sign.” Vomiting was the most common clinical sign observed (12/14), followed by abdominal pain in a small majority of cases (8/14). Severe abdominal pain and hypovolemic shock were uncommon in the patients reported (3/14). Colonic torsion should be considered as a differential diagnosis for dogs with radiographic segmental colonic distention with displacement of the descending colon and cecum. Barium enema is recommended for more definitive diagnosis.  相似文献   

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