Sullivan Eileen K, Callan Robert J, Holt Timothy N, Van Metre David C
Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA.
Vet Surg. 2005 Sep-Oct;34(5):524-9. doi: 10.1111/j.1532-950X.2005.00079.x.
To describe clinical findings, surgical treatment, and outcome associated with trichophytobezoar duodenal obstruction in New World camelids.
Retrospective study.
Alpacas (7) and 1 llama.
Historical and clinical data were obtained from the medical records of New World camelids with a diagnosis of trichophytobezoar duodenal obstruction confirmed by surgical exploration or necropsy.
Seven camelids were <1 year old. Abnormal clinical findings included anorexia, reduced fecal output, recumbency, colic, abdominal distension, regurgitation, decreased serum chloride concentration, increased serum bicarbonate concentration, and/or elevated first gastric compartment chloride concentration. Survey abdominal radiographs obtained (4 animals) revealed gastric distension (4) and/or visualization of the obstruction (2). Diagnosis was confirmed at necropsy (1) or surgery (7). Right paracostal celiotomy was performed on all animals and duodenotomy (3) or retropulsion of the trichophytobezoar combined with third compartment gastrotomy (4) was used to remove the obstruction. Six animals survived to discharge and 5 were healthy at follow-up, 8-20 months later. The remaining discharged alpaca was healthy at 12 months but subsequently died of unrelated causes.
Diagnosis of trichophytobezoar duodenal obstruction should be considered in juvenile New World camelids with abdominal distension and hypochloremic metabolic alkalosis. Right paracostal celiotomy can be used for access to the descending duodenum and third gastric compartment for surgical relief of obstruction.
Duodenal obstruction from bezoars should be considered in New World camelids <1year of age with abdominal distension and hypochloremic metabolic alkalosis. Surgical relief of the obstruction by right paracostal celiotomy has a good prognosis.
描述新大陆骆驼科动物毛滴虫性胃石导致十二指肠梗阻的临床症状、手术治疗及预后情况。
回顾性研究。
7只羊驼和1只美洲驼。
从经手术探查或尸检确诊为毛滴虫性胃石导致十二指肠梗阻的新大陆骆驼科动物病历中获取病史及临床资料。
7只骆驼科动物年龄小于1岁。异常临床症状包括厌食、粪便排出量减少、卧地不起、腹痛、腹胀、反流、血清氯浓度降低、血清碳酸氢盐浓度升高和/或第一胃室氯浓度升高。对4只动物进行的腹部X线平片检查显示胃扩张（4例）和/或梗阻显影（2例）。尸检（1例）或手术（7例）确诊。所有动物均行右肋缘下剖腹术，采用十二指肠切开术（3例）或毛滴虫性胃石后推术联合第三胃室胃切开术（4例）解除梗阻。6只动物存活出院，5只在8 - 20个月后的随访中健康。其余出院的羊驼在12个月时健康，但随后死于无关原因。
对于出现腹胀和低氯性代谢性碱中毒的幼年新大陆骆驼科动物，应考虑毛滴虫性胃石导致十二指肠梗阻的诊断。右肋缘下剖腹术可用于进入降部十二指肠和第三胃室以手术解除梗阻。
对于年龄小于1岁、出现腹胀和低氯性代谢性碱中毒的新大陆骆驼科动物，应考虑胃石导致的十二指肠梗阻。通过右肋缘下剖腹术手术解除梗阻预后良好。
