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1.
Six normal, healthy horses age 3-10 years underwent left and right thoracoscopic examination using a rigid telescope. A minimum of 30 days was allowed between procedures. Horses were restrained in stocks and sedated with a continuous detomidine infusion. After surgical preparation of the hemithorax elected for surgery, and administration of local or regional anaesthesia of the surgery sites, thoracoscopy was completed during two 15 min pneumothorax periods. During the procedures, the thoracic structures were viewed using a 57 cm, 10 mm diameter, 30 degrees rigid telescope connected to a digital camcorder to allow computer capture of digital images. The telescope was inserted into the thoracic cavity via 3 different intercostal spaces. The 8th, 10th and 12th intercostal spaces were randomly selected and used among horses. The exploration of each hemithorax started from the dorsal-caudal quadrant continued toward the cranial thorax and was completed by observing the diaphragmatic and caudal pulmonary region. Collapsed lung, aorta, oesophagus and diaphragm were viewed readily in either hemithorax. On exploration of the right hemithorax, the azygos vein, thoracic duct and pulmonary veins were also identified. Horses tolerated thoracoscopy well. Signs of discomfort, such as increased respiratory rate, coughing and decreased level of sedation, were associated with lung collapse in one horse, with pneumothorax on 2 occasions, and when the thorax was approached through the 8th intercostal space. Surgery performed via the 8th intercostal space was hindered by the rigidity of the 8th and 9th ribs, and by the presence of a greater musculature, which did not allow easy cranial and caudal movements of the telescope.  相似文献   

2.
CASE DESCRIPTION: A 2-year-old Siberian Husky was evaluated because of a 2-week history of coughing and gagging and decreased appetite and activity level. CLINICAL FINDINGS: Radiography, surgery, and immunohistochemical examination revealed a solitary sclerosing mesothelioma extending from the left thoracic diaphragmatic surface that was adherent to the pericardium and the caudal mediastinum. TREATMENT AND OUTCOME: The tumor was resected along with most of the left hemidiaphragm, and the left transversus abdominis muscle was used to reconstruct the diaphragm. The 13th rib formed the base of the muscle flap. The muscle flap was transposed into the defect so that the mesothelium-lined surface faced the thoracic cavity and the deep aspect of the muscle formed the abdominal surface of the diaphragm. To minimize risk of adhesions, the exposed raw aspect of the abdominal surface was covered with porcine small intestinal submucosa. Recovery was uncomplicated, and the dog's appetite and activity level soon returned to normal. Evaluation 54 days after surgery revealed 2 subcutaneous masses on the thorax and masses in the liver and both kidneys; histologic and immunohistochemical analyses revealed metastasis of the original tumor. The dog was euthanatized. CLINICAL RELEVANCE: Hemidiaphragmatic reconstruction with a transversus abdominis muscle flap after resection of a diaphragmatic tumor was successful. The muscle flap was easily harvested and transposed into the diaphragmatic defect.  相似文献   

3.
Five cavalier King Charles spaniels were examined for acute onset of respiratory distress. Thoracic radiographs demonstrated diaphragmatic hernia and tension gastrothorax, visible as a distended stomach occupying the left caudal thoracic cavity. Exploratory midline coeliotomy confirmed congenital pleuroperitoneal diaphragmatic hernia with herniation and dilatation of the stomach. The hernia configuration was consistent in all cases, with a defect affecting the left diaphragmatic crus. Congenital pleuroperitoneal diaphragmatic hernia is a rare condition caused by a defect in the dorsolateral diaphragm. Defects of the left crus of the diaphragm could result in the herniation of the stomach into the thoracic cavity with possible subsequent tension gastrothorax. Cavalier King Charles spaniels may have a predisposition to this condition. Tension gastrothorax is an acute life‐threatening consequence of gastric herniation through a diaphragmatic defect that must be promptly recognised and surgically treated.  相似文献   

4.
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5.
An 18‐year‐old Arabian‐mix mare was presented with a history of severe colic. Emergency exploratory celiotomy revealed diaphragmatic hernia, with a large rent in the left dorsal aspect of the diaphragm and large colon volvulus. Attempts to close the defect in the diaphragm in dorsal recumbency were unsuccessful. Therefore, a thoracic approach through lateral thoracotomy was elected, and a mesh was attached to the diaphragm using skin staples. While in dorsal recumbency, the mare suffered from significant respiratory acidosis. Thus, the mare was tilted into reverse Trendelenburg (30° head upward) and ventilation improved markedly. The mare recovered uneventfully, and was doing well 5 years after surgery.  相似文献   

6.
The effect of lung inflation on thoracic radiographic anatomy was determined in seven anesthetized calves less than one week of age. Radiographs were taken with the calves in dorsoventral (DV), ventrodorsal (VD), left and right lateral recumbency at functional residual capacity (FRC), at half inflation of the lung and at total lung capacity (TLC). Lung volumes were maintained by positive pressure ventilation. Increases in areas and linear dimensions during lung inflation were not uniform, being greatest in the caudal and especially the caudal ventral regions of the thorax. With inflation, heart size decreased and the heart shadow moved cauded as the diaphragm flattened. When the calf was shifted from the DV to the VD position, the heart displaced toward the left thoracic wall. Lung areas were larger on VD than on DV projections with the right lung being larger than the left. On lateral radiographs the most reliable, easily observed indication of the stage of lung inflation was the area bounded by the vena cava, the caudal heart border and the diaphragm. On the DV or VD radiographs the transthoracic width at the diaphragm was the best indicator of the degree of lung inflation.  相似文献   

7.
Objective— To report the use of thoracoscopic thoracic duct ligation (TDL) and pericardectomy for treatment of chylothorax.
Study Design— Case series.
Animals— Dogs with chylothorax (n=12).
Methods— Dogs with secondary or idiopathic chylothorax had thoracoscopy performed in sternal recumbency through 3 portals in the caudal right hemithorax for TDL and were then repositioned in dorsal recumbency for pericardectomy. Portals were placed in the 5th and 7th intercostal spaces of the right hemithorax with 1 transdiaphragmatic portal in the right paraxiphoid position. Follow-up was performed by recheck examination or telephone interview to determine outcome.
Results— Seven dogs (58%) had idiopathic chylothorax; 6 dogs (85.7%) had complete resolution of their effusion, whereas only 2 of the 5 nonidiopathic dogs (40%) had complete resolution.
Conclusions— Thoracoscopy is minimally invasive, provides excellent observation, and allows for ligation of the thoracic duct in the caudal thorax. Patients with idiopathic chylothorax may have a better prognosis after TDL and pericardectomy than dogs with nonidiopathic chylothorax.
Clinical Relevance— Thoracoscopy for ligation of the thoracic duct and pericardectomy is an acceptable surgical technique for treatment of chylothorax.  相似文献   

8.
A neutered male German shorthaired pointer sustained severe bite wounds to the left caudal flank and thigh area. Thorough wound lavage and debridement was performed immediately and also three days after presentation. Daily wound dressing resulted in the production of a mature granulation tissue bed. Prior to wound closure, colour flow Doppler ultrasonography was used to confirm blood flow through the right and left caudal superficial epigastric arteries and veins. Sixteen days after presentation, right and left caudal superficial epigastric axial pattern flaps were simultaneously elevated to cover the defect. The right flap was elevated as an island flap, rotated 120 degrees and used to cover the caudodorsal aspect of the defect. The left flap was elevated and rotated dorsally to cover the cranioventral aspect of the defect. Ninety per cent wound coverage was achieved and flap survival was total. The donor site defect was closed primarily and no dehiscence occurred. Three months postsurgery, the entire defect was closed and limb function was normal.  相似文献   

9.
Six healthy, awake, and pharmacologically restrained mature horses were studied in order to define the changes in cardiopulmonary function during and after exploratory thoracoscopy and to determine the presence of postoperative complications occurring 48 hours after thoracoscopy. In a randomised 3 x 3 latin square design with 2 replications, 18 procedures were performed: 6 right (RTH) and 6 left thoracoscopies (LTH) and 6 sham procedures (STH). Prior to each procedure a physical examination and a bronchoalveolar lavage fluid analysis were performed. During thoracoscopy and sham protocols, horses were sedated with a continual drip of detomidine HCl and data were collected at 6 time intervals: T1 (baseline), T2 (10 min detomidine administration), T3 (first 15 min pneumothorax), T4 (5 min recovery from pneumothorax), T5 (second 15 min pneumothorax), and T6 (10 min recovery from the second pneumothorax and detomidine). An endoscopic thoracic examination was conducted during the 2 pneumothorax periods. An identical protocol was followed for sham procedures without surgery or pneumothorax. Data were analysed by ANOVA with time and surgical procedure as main factors. Physical examinations, thoracic radiography and ultrasound, CBC and bronchoalveolar lavage fluid analysis were performed 48 h after thoracoscopy. Heart rate, respiratory rate, and cardiac output decreased following detomidine administration. There was a trend for cardiac output to be lower during thoracoscopy. Mild systemic hypertension was associated with thoracoscopy although there was no effect on pulmonary arterial pressure. Total and pulmonary vascular resistances were increased following detomidine administration. Thoracoscopy caused a further increase in systemic and pulmonary vascular resistances especially during the second pneumothorax. Arterial O2 tension decreased following detomidine administration and was further decreased during the second pneumothorax period. PaO2 values were lower when thoracoscopy was performed on the left rather than the right hemithorax. No significant complications were found during the 48 h follow-up evaluation. A subclinical postoperative pneumothorax occurred in 2 horses, one of which had sustained a lung laceration by the trocar. Thoracoscopy performed in healthy, awake, and pharmacologically restrained horses did not have detrimental cardiopulmonary effects and did not cause postoperative complications within the first 48 h period.  相似文献   

10.
Reconstruction of the caudal thoracic wall using the technique of diaphragmatic advancement is described in two dogs. The technique effectively reestablishes integrity of the thoracic cavity following resection of the thoracic wall supported by ribs 9 through 13. The diaphragm is incised near its peripheral attachments, advanced forward, and sutured to the epaxial musculature and the intercostal muscles of the most caudal intact rib. Diaphragmatic advancement is simple to perform and gives satisfactory cosmetic results, eliminating the need for more complex procedures such as tissue grafts or the use of prosthetic materials.  相似文献   

11.
Computed tomographic (CT) lymphography was performed in cats using percutaneous ultrasound‐guided injection of contrast medium into a mesenteric lymph node. The thoracic duct and its branches were clearly delineated in CT images of seven cats studied. The thoracic duct was characterized by anatomic variation and appeared as single or multiple branches. The thoracic duct and the cisterna chyli were identified along the ventral or left ventral aspect of the vertebrae from the level of the cranial lumbar to the caudal cervical vertebrae. The thoracic duct was identified in the central caudal mediastinum, deviated to the left in the cranial mediastinum, and finally moved toward the venous system. Small volumes of extranodal contrast medium leakage were identified in all cats. After injection, the mesenteric lymph nodes were cytologically normal. Ultrasound‐guided CT lymphography via percutaneous mesenteric lymph node injection appears safe and effective in cats.  相似文献   

12.
Outcomes of Heimlich valve drainage in dogs   总被引：1，自引：1，他引：0  
Objective and design   Retrospective study of the outcomes of Heimlich valve drainage in dogs.
Procedure   Medical records of the past 3 years were retrospectively reviewed. Heimlich valve drainage was used in 34 dogs (median body weight 30 ± 5 kg): lobectomy (n = 15), pneumonectomy (n = 9), intrathoracic oesophageal surgery (n = 2), diaphragmatic hernia repair (n = 1), traumatic open pneumothorax (n = 2), bilobectomy (n = 2), ligation of the thoracic duct (n = 1), and chylothorax and pneumothorax (n = 1 each). Evacuation of air and/or fluid from the pleural cavity was performed with the Heimlich valve following thoracostomy tube insertion. During drainage, the dogs were closely monitored for possible respiratory failure. Termination of Heimlich valve drainage was controlled with underwater seal drainage and assessed with thoracic radiography.
Results   Negative intrathoracic pressure was provided in 29 dogs without any complications. Post pneumonectomy respiratory syncope and post lobectomy massive hemothorax, which did not originate from the Heimlich valve, were the only postoperative complications. Dysfunction of the valve diaphragm, open pneumothorax and intrathoracic localisation of an acute gastric dilatation–volvulus syndrome caused by a left-sided diaphragmatic hernia following pneumonectomy were the Heimlich valve drainage complications.
Conclusions   The Heimlich valve can be used as a continuous drainage device in dogs, but the complications reported here should be considered by veterinary practitioners.  相似文献   

13.
Objective: To describe a novel surgical technique for management of right dorsal colitis in the horse. Study Design: Clinical report. Animals: 14‐year‐old Warmblood gelding. Methods: The horse was referred for treatment of a stromal abscess and signs of right dorsal colitis. Plasma chemistry revealed marked hypoproteinemia. Abdominal ultrasonographic examination showed a thickened right dorsal colon (RDC). Medical treatment was unsuccessful. With the horse in left lateral recumbency under general anesthesia, an approach to the right side of the abdomen through a 16th rib resection was made. The thoracic cavity was entered during the approach. Surgical resection of the RDC and side‐to‐side anastomosis of the diaphragmatic flexure to the small colon (bypass) was performed. The thoracic cavity was closed by attaching the diaphragm to the body wall and air was removed at the completion of surgery. Results: Resection of the RDC and bypass of the resected area was successfully performed. The colic signs and hypoproteinemia resolved. Complications of surgery included a deep surgical site infection with development of a large intrathoracic abscess. The abscess was managed with drainage and long‐term antimicrobial treatment. Conclusion: Right dorsal colitis can be treated successfully with resection and bypass of the RDC. In cases where the thoracic cavity is penetrated during the abdominal approach, the diaphragm should be sutured to the body wall at the beginning of surgery to avoid development of an infection within the thoracic cavity. Clinical Relevance: RDC resection and bypass may be an alternative approach for management of horses with right dorsal colitis.  相似文献   

14.
Pneumothorax in cattle can develop subsequent to acute or chronic pulmonary disease, and if unresolved may lead to respiratory distress and death due to hypoxia and compression and collapse of cardiac and thoracic great vessels. Therapeutic evacuation of free air within the pleural space can provide acute relief and improve chances of survival. This article descibes the adaptation and use of a continuous flow evacuation device to resolve pneumothorax in 3 cattle with pneumothorax associated with infectious lower airway disease.  相似文献   

15.
The ringed seal ( Phoca hispida ), as well as other seals, exhibit some unique anatomical properties when compared to their terrestrial counterparts. In the ringed seal, the most conspicuous adaptation is the aortic bulb, a large dilatation of the ascending aorta, which is comparable to that found in other seal species and marine mammals. Coronary arteries are similar to those of terrestrial mammals. The branches of the ascending aorta (brachiocephalic trunk, left common carotid artery and left subclavian artery) are similar to those of higher primates and man. The pulmonary trunk originates from the right ventricle near the ventral midline of the thorax. The peculiarities of the venous system are three pulmonary veins, a pericardial venous plexus, a caval sphincter, a hepatic sinus with paired caudal vena cavae and a large extradural venous system. Generally, three pulmonary veins (right, left, middle) empty into the left atrium. The right and left pulmonary veins drain the cranial and middle lung lobes of their respective lung, while the middle pulmonary vein drains both caudal lung lobes and the accessory lobe. The pericardial venous plexus lies on the pericardial pleura on the auricular (ventral) surface the heart. The azygous vein is formed from the union of right and left azygous veins near the 5th thoracic vertebra. The caval sphincter surrounds the caudal vena cava as it passes through the diaphragm. Caudal to the diaphragm, the vena cava is dilated excessively (the hepatic sinus) and near the kidneys it is biphid. Cardiovascular physiological studies have shown some of these anatomical variations, especially of the venous system and the ascending aorta, to be modifications for diving.  相似文献   

16.
The ringed seal (Phoca hispida), as well as other seals, exhibit some unique anatomical properties when compared to their terrestrial counterparts. In the ringed seal, the most conspicuous adaptation is the aortic bulb, a large dilatation of the ascending aorta, which is comparable to that found in other seal species and marine mammals. Coronary arteries are similar to those of terrestrial mammals. The branches of the ascending aorta (brachiocephalic trunk, left common carotid artery and left subclavian artery) are similar to those of higher primates and man. The pulmonary trunk originates from the right ventricle near the ventral midline of the thorax. The peculiarities of the venous system are three pulmonary veins, a pericardial venous plexus, a caval sphincter, a hepatic sinus with paired caudal vena cavae and a large extradural venous system. Generally, three pulmonary veins (right, left, middle) empty into the left atrium. The right and left pulmonary veins drain the cranial and middle lung lobes of their respective lung, while the middle pulmonary vein drains both caudal lung lobes and the accessory lobe. The pericardial venous plexus lies on the pericardial pleura on the auricular (ventral) surface the heart. The azygous vein is formed from the union of right and left azygous veins near the 5th thoracic vertebra. The caval sphincter surrounds the caudal vena cava as it passes through the diaphragm. Caudal to the diaphragm, the vena cava is dilated excessively (the hepatic sinus) and near the kidneys it is biphid. Cardiovascular physiological studies have shown some of these anatomical variations, especially of the venous system and the ascending aorta, to be modifications for diving.  相似文献   

17.
The ringed seal [Pusa (Phoca) hispida], as well as other seals, exhibits unique anatomical properties when compared to its terrestrial counterparts. In the ringed seal, the most conspicuous marine adaptation is the aortic bulb. This large dilatation of the ascending aorta is comparable to that found in other seal species and marine mammals. The branches of the ascending aorta (brachiocephalic trunk, left common carotid artery and left subclavian artery) are similar to those of higher primates and man. The peculiarities of the venous system are: three pulmonary veins, a pericardial venous plexus, a caval sphincter, a hepatic sinus with paired caudal vena cavae and a large extradural venous plexus. Generally, three common pulmonary veins (right, left and caudal) empty into the left atrium. The pericardial venous plexus lies deep to the mediastinal pericardial pleura (pleura pericardica) on the auricular (ventral) surface of the heart. The caval sphincter surrounds the caudal vena cava as it passes through the diaphragm. Caudal to the diaphragm, the vena cava is dilated (the hepatic sinus), and near the cranial extremity of the kidneys, it becomes biphid. The azygos vein is formed from the union of the right and left azygos veins at the level of the 5th thoracic vertebra. Cardiovascular physiological studies show some of these anatomical variations, especially of the venous system and the ascending aorta, to be modifications for diving. This investigation documents the large blood vessels associated with the heart and related structures in the ringed seal.  相似文献   

18.
Seven puppies with concomitant congenital cranioventral abdominal wall, caudal sternal, diaphragmatic, and pericardial defects were treated surgically when they were between 10 and 12 weeks old. Three pups had ventricular septal defects that were not corrected. Diaphragmatic herniorrhaphy without extension of the diaphragmatic defect was performed in 6 pups. In one pup, paracostal extension of the diaphragmatic defect was necessary to decrease tension on the diaphragmatic closure. All pups were healthy at 6-month follow-up examinations, but 2 of 3 pups with ventricular septal defects had moderate generalized cardiomegaly evident on thoracic radiography. Early surgical correction of the congenital defects in these pups was usually simple because there were few or no thoracic adhesions, the dogs were small, the defects were small in 6 of 7 dogs, and the costal arch was pliable in each dog.  相似文献   

19.
A 2 yr old female English setter dog was admitted for acute dyspnea. The dog underwent treatment of a T9T10 thoracic vertebral fracture subluxation at the authors' institution 15 mo earlier. Upon admission, a chest X-ray revealed a pneumothorax and a metallic foreign body in the left hemithorax. An emergency video-assisted thoracoscopic surgery was successfully performed to remove a 4.6-mm long Kirschner wire that migrated from the thoracic vertebral column to the thoracic cavity. The operating time was 27 min. The dog made an uneventful recovery and was discharged on the third day after surgery. Pneumothorax should be considered in patients that develop acute dyspnea and have a history of wire fixation in the thoracic vertebral column. Video-assisted thoracoscopic surgery is a safe and effective treatment of this condition.  相似文献   

20.
A 5-year-old Thoroughbred gelding was examined because of a small axillary wound sustained 5 days earlier and had resulted in extensive subcutaneous emphysema. Three days after admission, the horse's respiratory rate had increased to 72 breaths/min, and the horse appeared anxious and distressed. Thoracic radiography revealed pneumomediastinum and severe bilateral pneumothorax. Tube thoracostomy was performed on both hemithoraxes. The drains were connected to one-way suction valves and suction devices to decompress the thorax. A nasopharyngeal catheter was inserted, and oxygen insufflation was started. Cross ties were placed on the horse to limit movement, and the wound was packed. The horse improved within 30 minutes after initiating treatment. The horse was released 15 days after the development of pneumothorax, at which time the pneumothorax had resolved, the wound was no longer open, and the subcutaneous emphysema had greatly decreased. Although subcutaneous emphysema is usually regarded as a temporary cosmetic disfigurement, it can lead to serious complications such as pneumothorax. This case demonstrates that subcutaneous emphysema can lead to a life-threatening pneumothorax if the pressure is great enough to migrate through the mediastinum and into the pleural cavity. Horses with subcutaneous emphysema should be kept in confinement and monitored for the development of pneumothorax.  相似文献   

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