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使用腹直肌皮瓣修复犬膀胱和尿道缺损

Use of a rectus abdominis muscle flap to repair urinary bladder and urethral defects in a dog.

作者信息

Savicky Roman S, Jackson Andrew H

机构信息

Michigan Veterinary Specialists, Southfield, MI 48034, USA.

出版信息

J Am Vet Med Assoc. 2009 Apr 15;234(8):1038-40. doi: 10.2460/javma.234.8.1038.

Abstract

CASE DESCRIPTION

An 11-month-old female dog was evaluated because of a 3- to 4-day history of stranguria and hematuria.

CLINICAL FINDINGS

Rectal and vaginal examination and abdominal radiography revealed a large (4 x 2 cm), firm, ovoid object in the area of the pelvic inlet, between the vagina and colon.

TREATMENT AND OUTCOME

Surgical exploration revealed an abscess and moderate amount of seropurulent fluid in the left caudal abdominal quadrant. A large urethrolith (3.7 x 2.0 x 1.5 cm) was evident in the proximal portion of the urethra. The urethrolith was associated with a 3 x 1-cm area of necrosis in the ventral aspect of the proximal portion of the urethra and a 3 x 3-cm area of necrosis in the area of the bladder trigone. The necrotic areas were débrided, and the defect was repaired with an axial pattern flap constructed from the rectus abdominis muscle. During a follow-up examination 2.5 years after surgery, the dog was clinically normal with no history of urinary incontinence. During rigid cystoscopy, the ure-thral mucosa appeared grossly normal, and there was no evidence of stricture.

CLINICAL RELEVANCE

Findings suggested that axial pattern flaps constructed from the rectus abdominis muscle flap may be useful in reconstructing large urinary bladder and urethral defects.

摘要

病例描述

一只11个月大的雌性犬因出现3至4天的排尿困难和血尿症状而接受评估。

临床检查结果

直肠和阴道检查以及腹部X光检查显示,在盆腔入口区域、阴道和结肠之间有一个大的(4×2厘米)、坚硬的椭圆形物体。

治疗及结果

手术探查发现左下腹象限有一个脓肿和中等量的浆液脓性液体。在尿道近端可见一个大的尿道结石(3.7×2.0×1.5厘米)。该尿道结石与尿道近端腹侧一个3×1厘米的坏死区域以及膀胱三角区一个3×3厘米的坏死区域相关。对坏死区域进行清创,并用由腹直肌构建的轴型皮瓣修复缺损。在术后2.5年的随访检查中,该犬临床正常,无尿失禁病史。在硬性膀胱镜检查中,尿道黏膜外观大体正常,无狭窄迹象。

临床意义

研究结果表明,由腹直肌皮瓣构建的轴型皮瓣可能有助于重建大的膀胱和尿道缺损。

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