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四例患有血管环异常的羊驼幼崽和一例美洲驼幼崽的食管功能障碍。

Esophageal dysfunction in four alpaca crias and a llama cria with vascular ring anomalies.

作者信息

McKenzie Erica C, Seguin Bernard, Cebra Christopher K, Margiocco Marco L, Anderson David E, Löhr Christiane V

机构信息

Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, USA.

出版信息

J Am Vet Med Assoc. 2010 Aug 1;237(3):311-6. doi: 10.2460/javma.237.3.311.

Abstract

CASE DESCRIPTION

3 alpaca crias and cadavers of an alpaca cria and a llama cria were evaluated for evidence of esophageal dysfunction.

CLINICAL FINDINGS

All 5 crias were between 3 and 5 months of age when clinical signs developed, and all had a thin body condition when examined. Clinical signs included coughing, regurgitation, and grossly visible esophageal peristaltic waves. A barium esophagram was used to diagnose esophageal obstruction, megaesophagus, and a vascular ring anomaly (VRA). Fluoroscopy was used to evaluate deglutition, esophageal peristalsis, and the extent of esophageal dilation in 1 alpaca cria. A persistent right aortic arch was identified in 1 alpaca cria, and a left aortic arch with right ductus arteriosus or ligamentum arteriosum and an aberrant right subclavian artery were identified in the 4 remaining crias.

TREATMENT AND OUTCOME

Surgical correction of the VRA was attempted in the 3 live alpaca crias. It was complicated by the conformation and location of each VRA and inaccurate anatomic diagnosis of the VRAs before surgery. Treatment was universally unsuccessful because of intraoperative complications and the persistence of clinical signs after surgery.

CLINICAL RELEVANCE

Megaesophagus is typically an idiopathic condition in camelids. However, these findings suggested that camelids with esophageal dysfunction during the neonatal period may have a VRA. The prognosis is grave for camelids with VRA, and accurate anatomic diagnosis of the VRA via the use of advanced imaging techniques (eg, angiography, computed tomography, or magnetic resonance imaging) may improve the success of surgical intervention.

摘要

病例描述

对3只羊驼幼崽以及1只羊驼幼崽和1只美洲驼幼崽的尸体进行了食管功能障碍证据的评估。

临床发现

所有5只幼崽出现临床症状时年龄在3至5个月之间,检查时身体状况均较消瘦。临床症状包括咳嗽、反流以及肉眼可见的食管蠕动波。使用硫酸钡食管造影来诊断食管梗阻、巨食管和血管环异常(VRA)。对1只羊驼幼崽使用荧光镜检查来评估吞咽、食管蠕动以及食管扩张程度。在1只羊驼幼崽中发现持续性右主动脉弓,在其余4只幼崽中发现左主动脉弓伴右动脉导管或动脉韧带以及迷走右锁骨下动脉。

治疗与结果

对3只存活的羊驼幼崽尝试进行VRA的手术矫正。由于每个VRA的形态和位置以及术前对VRA的解剖诊断不准确,手术过程复杂。由于术中并发症以及术后临床症状持续存在,治疗普遍未成功。

临床意义

巨食管在骆驼科动物中通常是一种特发性疾病。然而,这些发现表明,新生期出现食管功能障碍的骆驼科动物可能存在VRA。患有VRA的骆驼科动物预后严重,通过使用先进的成像技术(如血管造影、计算机断层扫描或磁共振成像)对VRA进行准确的解剖诊断可能会提高手术干预的成功率。

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