Sherlock Ceri E, Eggleston Randall B
Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA 30605.
J Am Vet Med Assoc. 2013 Dec 1;243(11):1596-601. doi: 10.2460/javma.243.11.1596.
To determine the clinical signs, treatment, and prognosis for horses with impaction of the cranial aspect of the base of the cecum (cecal cupula).
Retrospective observational case series.
7 horses with colic attributed to cecal cupula impaction.
Medical records were reviewed and horses that underwent exploratory celiotomy from 2000 through 2010 were identified. Horses with cecal cupula impaction and without other abdominal problems to which colic could be attributed were selected for inclusion in the study. Information regarding history, clinical findings, diagnostic testing, surgical findings and treatments, and treatments and complications after surgery was recorded. Rate of survival of horses to discharge from the hospital was determined. Long-term follow-up information was obtained with telephone questionnaires.
Cecal cupula impaction without other cecal abnormalities was identified in 7 horses during exploratory celiotomy. Although clinical signs varied, horses typically had mild signs of colic and nondiagnostic rectal examination findings but were in systemically stable conditions at the time of the initial evaluation. Typhlotomies were performed and impactions were resolved by means of lavage and evacuation. All horses survived to discharge from the hospital and lived ≥ 2 years after surgery.
Results of this study suggested cecal cupula impaction was a novel type of cecal impaction that was uncommon. Impactions did not involve the cecal body or apex and hypertrophy of the cecal wall was not grossly detected. Impactions were successfully treated with typhlotomy, lavage, and evacuation. Horses had a good prognosis after surgical treatment.
确定患有盲肠底部头侧(盲肠圆顶)阻塞的马匹的临床体征、治疗方法及预后情况。
回顾性观察病例系列。
7匹因盲肠圆顶阻塞而患绞痛的马。
查阅病历,确定2000年至2010年间接受剖腹探查术的马匹。选择患有盲肠圆顶阻塞且无其他可归因于绞痛的腹部问题的马匹纳入研究。记录有关病史、临床检查结果、诊断性检测、手术所见及治疗情况,以及术后治疗及并发症的信息。确定马匹出院时的存活率。通过电话问卷调查获取长期随访信息。
在剖腹探查术中,7匹马被确诊为盲肠圆顶阻塞,无其他盲肠异常情况。尽管临床体征各异,但马匹通常有轻度绞痛体征,直肠检查结果无诊断意义,但在初次评估时全身状况稳定。进行了盲肠切开术,通过冲洗和排空解决了阻塞问题。所有马匹均存活至出院,术后存活≥2年。
本研究结果表明,盲肠圆顶阻塞是一种新型的、少见的盲肠阻塞类型。阻塞不涉及盲肠体部或尖端,未明显发现盲肠壁肥大。盲肠切开术、冲洗和排空成功治疗了阻塞。手术治疗后马匹预后良好。