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1.
Fourteen horses with cecal impaction were treated by cecocolic anastomosis. In nine horses, the anastomosis followed enterotomy and evacuation of the cecal contents, and in two horses it followed saline infusion and massage of the cecum. In three horses, the anastomosis was the only surgical procedure performed. Cecocolic anastomosis was performed between the lateral and dorsal cecal teniae, and the lateral and medial free teniae of the right ventral colon. The anastomosis was hand sutured in five horses. In all other horses, the GIA surgical stapling instrument was used in combination with hand sutured seromuscular layer closures and became the preferred surgical technique. The anastomosis allowed an alternative route for the transit of ingesta from the cecum to the right ventral colon.
Twelve of the 14 horses survived 2 months or longer after surgery (short-term survival rate, 86%) and 10 horses survived 12 months or longer after surgery (long-term survival rate, 71%). Early postoperative complications included mild abdominal pain (6 horses), wound infections (3 horses), fatal peritonitis (2 horses), and large colon distention necessitating reoperation (2 horses).  相似文献   

2.
Several surgical alternatives have been described for the management of cecal impaction in the horse, but none has met with consistently successful results. This study was done to evaluate a surgical bypass of the cecum by anastomosis of the ileum to the right ventral colon (ileocolostomy). A ventral midline celiotomy was performed on nine adult ponies (155-350 kg) and a mechanically stapled 10 cm side-to-side ileocolostomy was created. In five ponies a complete cecal bypass (CCB) was created by transecting the ileum distal to the anastomosis. In the other four, an incomplete cecal bypass (ICB) was created with no interruption of the ileum. Six horses with clinical cecal impaction also underwent cecal bypass procedures. Five had a CCB and one had an ICB. All the ponies maintained body weight, had no change in consistency of the feces and had no abdominal pain during the 6 month observation period. At necropsy, the lengths of the lateral cecal band, lateral free band of the colon, and the diameter of the anastomotic stoma were compared to measurements made at surgery. The lateral cecal band length decreased significantly more in the CCB ponies than in the ICB ponies (p = 0.008). The anastomotic stoma diameter was significantly larger in the ICB group than in the CCB group (p = 0.032). Five of the six clinical cases recovered and returned to their previous activity. CCB by an ileocolostomy resulted in removal of the cecum from the functional flow of ingesta without complication in the ponies, and was successful in five clinical cases of cecal impaction.  相似文献   

3.
Chronic constipation, nonresponsive to medical management and associated with idiopathic megacolon, was diagnosed in 38 cats from 1979 to 1985. All cats were treated by subtotal colectomy and enterocolostomy, in which the ileum or distal portion of the jejunum was joined to a 2- to 4-cm segment of distal portion of the colon preserved to accommodate an end-to-end anastomosis. After surgery, cats usually were depressed and anorectic, had tenesmus, and passed liquid tarry feces. In 37 cats 1 week to 3 months after surgery, character of the feces changed from diarrhea to soft semiformed or formed feces. One cat had severe diarrhea that was nonresponsive to diet change and pharmacologic treatment; the diarrhea resolved after 4.5 months. One cat developed a stricture of the enterocolostomy, which was relieved by 3 balloon catheter dilatations. All cats regained normal appetite, did not lose weight, and were not incontinent. Three cats had sporadic episodes of constipation and were easily treated. Results of histologic examination of the resected portion of colon in 23 cats were inconclusive.  相似文献   

4.
Cecal dilatation and volvulus in dairy cows: 84 cases (1977-1983)   总被引：1，自引：0，他引：1  
The records of 84 cows with cecal dilatation or cecal volvulus were reviewed. The diagnosis was made by exploratory laparotomy or necropsy in 21 cows with cecal dilatation, and in 45 cows with cecal volvulus. Eighteen of the cows with cecal dilatation responded to medical management and the diagnosis was made by physical examination alone. The most useful criteria for determining that surgery was necessary were the presence of a high heart rate, apparent abdominal pain, scant or absence of feces, and the apex of the cecum rotated cranially on rectal examination. The prognosis for cattle with cecal dilatation and volvulus was good following medical therapy or decompression at surgery unless there was severe vascular compromise of the cecum. There was a 10% recurrence rate, and in these cows a partial typhlectomy was performed.  相似文献   

5.
The objective of this study was to identify risk factors and describe clinical signs in 7 foals with cecal rupture; none of the foals survived. Six foals had undergone general anesthesia; 5 for orthopedic procedures. Six of the foals were receiving nonsteriod anti-inflammatory drugs. Most foals started showing colic signs on day 2 after surgery, preceded in 3 cases by dullness. Cecal rupture occurred between 4 hours and 2 days after the first signs of colic were noticed. Intestinal motility was decreased or absent in all foals for which it was recorded.Foals undergoing general anesthesia should be closely monitored for any sign of dullness, prolonged recumbency, reduced fecal output, and signs of abdominal discomfort for 3 days postoperatively, especially in cases following orthopedic surgery. If any of the above occurs, cecal impaction should be considered as a differential diagnosis. A prompt exploratory laparotomy may be a reasonable diagnostic option before the cecum ruptures with fatal consequences.  相似文献   

6.
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   

7.
A 5-month-old alpaca cria was examined for chronic poor growth and repeated episodes of diarrhea. Examination of feces for parasites yielded negative results. Serum bile acid and blood ammonia concentrations were high. Subsequent examination by ultrasonography, percutaneous splenic portography, and colonic scintigraphy did not reveal evidence of a portosystemic vascular anomaly. Exploratory celiotomy with mesenteric vein portography revealed a colonic vein shunt in the caudal portion of the abdomen from the caudal vena cava to the portal vein. The shunt vessel was ligated without incident. Following surgery, the cria began to gain weight and was more alert. Eighteen months after surgery, the cria was doing well, although it had loose feces and was slightly small for its age. Portosystemic shunts are rare in cattle and horses but should be considered in alpacas with chronic poor growth when parasitism has been ruled out.  相似文献   

8.
This report describes the clinical course and surgical findings of a 5-year-old Warmblood gelding referred for colic with a previous history of intermittent colic episodes, and gastric ulcers diagnosed by gastroscopy in the preceding months. The horse underwent medical treatment but remained painful and surgery was elected. The horse underwent an exploratory laparotomy during which an impaction was identified in the transverse colon that was associated with an approximately 1 metre segment of nasogastric tube. The foreign body was removed via an enterotomy in the left dorsal colon, and the horse recovered well from surgery. No complications were encountered post-operatively.  相似文献   

9.
OBJECTIVE: To determine short- and long-term outcomes, including recurrence rates, for horses with cecal impaction treated medically or surgically. DESIGN: Retrospective case series. ANIMALS: 114 horses. PROCEDURES: Medical records were reviewed for information on signalment, history, clinical findings, treatment (medical vs surgical), and short-term outcome. Information on longterm outcome was obtained through a mail survey and telephone interview with owners. RESULTS: 54 horses were treated medically, 49 horses were treated surgically, and 11 horses were euthanized after initial examination without further treatment. Horses treated surgically were significantly more likely to have signs of moderate or severe pain than were horses treated medically. Forty-four of the 54 (81%) horses treated medically were discharged from the hospital. Twelve of the 49 horses treated surgically were euthanized at surgery because of cecal rupture. Thirty-five of the 37 (95%) horses that were allowed to recover from surgery were discharged from the hospital. In 34 horses treated surgically, typhlotomy without a bypass procedure was performed. Long-term (>or= 1 year) follow-up information was available for 19 horses treated medically and 28 horses treated surgically. Eighteen (95%) and 25 (89%) of the horses, respectively, were alive at least 1 year after treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that medical and surgical treatment were both associated with favorable outcomes in horses with cecal impactions. In this population, typhlotomy alone without cecal bypass was associated with a low recurrence rate. The long-term prognosis for horses that were discharged from the hospital was good.  相似文献   

10.
The influence of fiber source on fiber digestion in rabbits was investigated. Six fibrous feedstuffs with wide differences in chemical composition and particle size were selected: paprika meal, olive leaves, alfalfa hay, soybean hulls, sodium hydroxide-treated barley straw, and sunflower hulls. Six diets were formulated to contain one of these ingredients as the sole source of fiber. To avoid nutrient imbalances, fiber sources were supplemented with different proportions of a fiber-free concentrate, based on soy protein isolate, wheat flour, lard, and a vitamin and mineral mix, to obtain diets containing at least 3% nitrogen and 5% starch. Daily soft feces excretion, and its NDF, and total and microbial nitrogen content were determined in 60 fattening rabbits (10 per diet). Seven days after the last cecotrophy control, the same animals were used to determine weight of stomach, cecum and their contents, and cecal fermentation traits (pH, VFA and ammonia concentrations, and buffer properties of cecal contents). Stepwise regression analysis showed a positive effect (P < .001) on soft feces excretion, total and microbial nitrogen concentrations in soft feces, cecal acidity, and total VFA in the cecum of dietary pectic constituents (2.9, 3.5, 2.5, .9, and 6.6%) and proportion of fine particles (< .315 mm) (1.8, .9, 1.3, .15, and .9%) per each increment of one percentage unit of the independent variables. Proportion of fine particles also increased weight of cecal contents (P < .001). Soft feces excretion and weight of stomach and of its contents increased (P < .001) by 5.2, 2.8, and 10.2% per each percentage unit increment of proportion of large particles (> 1.25 mm). Degree of lignification of NDF decreased total nitrogen concentration in soft feces and cecal VFA concentration (P < .001). Source of fiber affected cecal pH not only by its influence on the cecal concentrations of the final products of fermentation, but also through its effect on the pH of dry cecal contents (P < .001). The latter was negatively correlated with dietary proportion of fine particles, degree of lignification of NDF, and base-buffering capacity of dry cecal contents (r = -.52, -.37, and -.49, respectively). From these results, we conclude that pectic constituent concentration, degree of lignification of NDF, and particle size are the variables that best characterize the influence of the source of fiber on soft feces excretion and cecal fermentation traits in rabbits.  相似文献   

11.
Cecal volvulus in a ewe   总被引：1，自引：0，他引：1  
Cecal volvulus in a ewe was diagnosed and surgically treated. Clinical signs were similar to those observed in cattle with cecal volvulus. Rectal palpation, which is an important diagnostic aid in cattle, was not possible in the ewe. Thus, the decision for surgery was based on clinical signs indicative of gastrointestinal obstruction, with the diagnosis of cecal volvulus being made at the time of surgery. Recovery after surgery was rapid, and follow-up evaluation at 13 months indicated no recurrence of the problem.  相似文献   

12.
OBJECTIVE: To evaluate the use of an intravitreal sustained-release cyclosporine (CsA) delivery device for treatment of horses with naturally occurring recurrent uveitis. ANIMALS: 16 horses with recurrent uveitis. PROCEDURES: Horses with frequent recurrent episodes of uveitis or with disease that was progressing despite appropriate medication were selected for this study. Additional inclusion criteria included adequate retinal function as determined by use of electroretinography, lack of severe cataract formation, and no vision-threatening ocular complications (eg, retinal detachment, severe retinal degeneration, and posterior synechia). Sustained-release CsA delivery devices (4 microg of CsA/d) were implanted into the vitreous through a sclerotomy at the pars plana. Reexaminations were performed 1, 3, 6, and 12 months after implantation, then continued annually. Ophthalmic changes, number of recurrent episodes of uveitis, and vision were recorded. RESULTS: The rate of recurrent episodes after device implantation (0.36 episodes/y) was less than prior to surgery (75 episodes/y). In addition, only 3 horses developed episodes of recurrent uveitis after surgery. Vision was detected in 14 of 16 affected eyes at a mean follow-up time of 13.8 months (range, 6 to 24 months). CONCLUSIONS AND CLINICAL RELEVANCE: This intravitreal sustained-release CsA delivery device may be a safe and important tool for long-term treatment of horses with chronic recurrent uveitis.  相似文献   

13.
A 14 year-old, spayed female Jack Russell terrier with a six month history of weight loss, lethargy, intermittent vomition and diarrhoea was diagnosed as having a chronic impaction of the caecum with mineralised faecal material. Diagnosis was based on the clinical findings and both survey and positive contrast radiographic studies. The diagnosis of caecal impaction was confirmed at surgery and a typhlectomy was performed with the aid of a linear stapler. Histopathology of the caecum confirmed the impaction to have resulted from faecolithlasis. The dog made a full recovery from the procedure, showing no recurrence of the clinical signs until euthanasia three months postoperatively for probable heart failure associated with mitral regurgitation.  相似文献   

14.
Megacolon with myenteric hypoganglionosis in a foal   总被引：1，自引：0，他引：1  
A 6-month-old Clydesdale filly had chronic abdominal distention and intermittent febrile episodes. Abdominal surgery revealed impaction of the right dorsal colon, which was relieved by evacuation of contents through an enterotomy. Four days after surgery, abdominal distention recurred and progressed. The filly was euthanatized. Necropsy revealed the right dorsal colon to be markedly distended with digesta. Microscopically, there was a marked reduction in myenteric ganglion cells in the right dorsal colon and cecum and mild to moderate reduction of myenteric ganglion cells in the left ventral and transverse colon.  相似文献   

15.
Medical records of 28 horses with impaction of the small colon were reviewed; 20 horses were admitted during the winter months. Diagnosis of small-colon impaction was made in 21 horses by rectal examination, and in 7 horses at exploratory celiotomy. Ten horses were treated medically, and 18 were treated surgically. Horses that were treated surgically were more likely to have abdominal distention than were those that responded to medical treatment (P less than 0.025). Signs of greater degree of abdominal pain and higher heart rate were seen in horses treated surgically, but these values were not significantly different from values in medically treated horses. Duration of hospitalization was less in horses treated medically (P less than 0.025). Long-term survival was higher for horses treated medically (P less than 0.025). All horses treated medically and 7 of the horses treated surgically were alive at follow-up evaluation, at least 1 year after discharge. Fever and diarrhea were common complications after surgery. Four horses were fecal culture-positive for Salmonella sp after surgery. Early and aggressive medical management of horses with impaction of the small colon is recommended.  相似文献   

16.
This report describes successful surgical correction and long-term survival of a case of large colon atresia in a 24-h-old Warmblood colt, referred with signs of unrelenting abdominal pain and a suspicion of meconium impaction. Radiographic and ultrasonographic examination was indicative of large colon meconium impaction with secondary ileus. Due to deterioration of the foal, surgery was recommended. An atretic segment was found between the left ventral and dorsal large (ascending) colon. A band of fibrous tissue with no identifiable lumen connected the segments. Surgical correction was done by performing a stapled side-to-side anastomosis. Twelve days after surgery, the foal was discharged. Twenty-two months after discharge, the owner reported the foal developing as expected compared with its peers, but had a mild, self-limiting episode of colic at 20 months of age.  相似文献   

17.
Surgical Treatment of Sand Colic Results in 40 Horses   总被引：1，自引：0，他引：1  
A retrospective study of 40 horses that underwent surgical treatment for sand colic was performed. Three horses were euthanatized and one died during surgery. Of the 36 horses that recovered from anesthesia, five died before discharge from the hospital and seven died after discharge. Twenty-four horses survived at least 12 months. Sand impaction of the right dorsal colon was present in 26 horses. In addition to sand impaction, 10 horses also had colonic displacement or volvulus.  相似文献   

18.
The cecum and ileocecocolic junction in each of five 7-month-old Holstein steers were removed. Two steers of the same breed and age were sham-operated. All steers survived and were subjected to a digestibility experiment for 16 weeks. Digestibility of dry matter, neutral-detergent fiber, acid-detergent fiber, and cellulose decreased (P less than 0.05) during postsurgical weeks (PSW) 1 to 4, but not during PSW 16. However, digestibility of protein and hemicellulose was not significantly (P less than 0.07) influenced by the operation. Digestibility of the previously described components was not significantly different from that in 2 sham-operated steers. The mean daily weight gain of the cecectomized steers decreased during PSW 1 to 4; however, it started to increase at PSW 8 so that at PSW 16 it approached preoperative values. The mean daily weight gain of the sham-operated steers also decreased during PSW 1 to 4, but was higher than the preoperative values at PSW 14. The difference in mean daily weight gains between the cecectomized and sham-operated steers was insignificant. The consistency of the feces of the cecectomized steers was loose to watery for a period of about 4 weeks after surgery. At PSW 16, the feces were firm, but not of normal consistency. Feces of the sham-operated steers were loose after surgery, but returned to normal consistency after approximately 7 days. Adhesions developed at the surgical site and involved the ileum, the proximal loop of the ascending colon, and the adjacent mesentery and greater omentum.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

19.
Surgical stapling equipment was used to perform an end-to-end colonic anastomosis in 15 cats for the treatment of acquired megacolon. An end-to-end stapling device was passed to the anastomotic site by a trans-cecal approach. Subsequent closure of the cecal incision was accomplished with a thoracoabdominal stapling device. Two cats had hemorrhagic episodes immediately after surgery that required blood transfusions. All 15 cats have had good to excellent health after subtotal colectomy and colocolostomy performed using this stapling technique. Results of this study have demonstrated that "single surgical field" placement of the end-to-end stapling device has the primary advantage of simplicity and a lower chance of contamination compared with (dual field) rectal passage of similar devices. Closure of the cecal access incision is easily performed without reducing the diameter of the large intestinal lumen. The stapling technique provided an efficient and consistent method for anastomosis of the large bowel in cats.  相似文献   

20.
本试验旨在比较肥胖型的金华猪和瘦肉型的长白猪肠道古菌结构的差异,分析菌群移植小鼠肠道古菌结构。采集金华猪和长白猪的新鲜粪便,通过灌胃移植到经广谱抗生素处理过的小鼠肠道中,提取2种猪粪便及其移植小鼠的盲肠内容物总基因组DNA,使用古菌通用引物对古菌16S rRNA的V4区进行PCR扩增,通过Illumina Hiseq测序平台对扩增产物进行高通量测序,使用QIIME等软件对测序序列进行分析统计。结果表明:金华猪和长白猪粪便及其移植小鼠盲肠内容物中的古菌主要包含3个门,分别为奇古菌门(Thaumarchaeota)、广古菌门(Euryarchaeota)和泉古菌门(Crenarchaeota),其中金华猪粪便中广古菌门的丰度高于长白猪;在属水平上主要包含4个已知属,优势属为餐古菌属(Cenarchaeum)。二者移植小鼠的盲肠内容物古菌结构,在门水平上,移植小鼠的奇古菌门比例占70%以上;奇古菌门的古菌几乎全部来源于餐古菌属;在门和属的水平上,金华猪和长白猪粪便移植小鼠的盲肠古菌结构无显著差异(P0.05),但基于操作分类单元(OTU)水平的主成分分析显示出很好的组内聚集。由此可见,奇古菌门的餐古菌属是金华猪和长白猪粪便和其移植小鼠盲肠中的优势古菌;金华猪粪便中广古菌门的丰度高于长白猪粪便,且二者移植小鼠盲肠内容物之间古菌结构在OTU水平上存在一定的差异。  相似文献   

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