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术前和术中超声辅助经腹正中剖腹术清除导致髂腰肌炎的游走性植物性物质:22只犬的研究

Preoperative and intraoperative ultrasound aids removal of migrating plant material causing iliopsoas myositis via ventral midline laparotomy: a study of 22 dogs.

作者信息

Birettoni Francesco, Caivano Domenico, Rishniw Mark, Moretti Giulia, Porciello Francesco, Giorgi Maria Elena, Crovace Alberto, Bianchini Erika, Bufalari Antonello

机构信息

Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126, Perugia, Italy.

Department of Clinical Sciences, Cornell University, Ithaca, NY, 14853, USA.

出版信息

Acta Vet Scand. 2017 Feb 14;59(1):12. doi: 10.1186/s13028-017-0280-5.

Abstract

BACKGROUND

Migrating plant material is often suspected clinically to be the underlying cause of iliopsoas myositis in the dog, but cannot always be found pre- or intraoperatively. In most cases, recurrence of clinical signs is related to failure to remove the plant material. Preoperative ultrasonography can be useful to visualize migrating plant material and to determine anatomical landmarks that can assist in planning a surgical approach. The purpose of the present study was to report the role of intraoperative (intra-abdominal) ultrasonography for visualizing and removing the plant material from iliopsoas abscesses using a ventral midline laparotomy approach.

RESULTS

A retrospective case series of 22 dogs with iliopsoas muscle abnormalities and suspected plant material was reported. Preoperative visualization and subsequent retrieval of the plant material was performed during a single hospitalization. In all 22 dogs, the plant material (including complete grass awns, grass awn fragments and a bramble twig) was successfully removed via ventral midline laparotomy in which intraoperative ultrasonography was used to direct the grasping forceps tips to the foreign body and guide its removal. In 11 of these 22 dogs, the plant material was not completely removed during prior surgery performed by the referring veterinarians without pre- or intraoperative ultrasonography. Clinical signs resolved in all dogs and all dogs resumed normal activity after successful surgical removal of the plant material.

CONCLUSION

Intraoperative ultrasonography is a safe and readily available tool that improves success of surgical removal of plant material within the iliopsoas abscesses via ventral midline laparotomy. Moreover, ultrasonographic findings of unusual plant material can be useful in planning and guiding surgical removal, by providing information about the size and shape of the foreign body.

摘要

背景

临床上常怀疑迁移性植物物质是犬髂腰肌炎的潜在病因,但术前或术中并非总能找到。在大多数情况下,临床症状的复发与未能清除植物物质有关。术前超声检查有助于观察迁移性植物物质,并确定有助于规划手术入路的解剖标志。本研究的目的是报告术中(腹内)超声检查在经腹正中剖腹术清除髂腰肌脓肿中植物物质的作用。

结果

报告了一项对22只患有髂腰肌异常且怀疑有植物物质的犬的回顾性病例系列研究。在一次住院期间进行了术前观察并随后取出了植物物质。在所有22只犬中,通过腹正中剖腹术成功取出了植物物质(包括完整的草芒、草芒碎片和一根荆棘小枝),术中使用超声引导抓钳尖端对准异物并指导其取出。在这22只犬中,有11只在转诊兽医之前进行的手术中,未进行术前或术中超声检查,植物物质未被完全清除。所有犬的临床症状均得到缓解,在成功手术取出植物物质后,所有犬都恢复了正常活动。

结论

术中超声检查是一种安全且易于使用的工具,可提高经腹正中剖腹术成功清除髂腰肌脓肿中植物物质的成功率。此外,超声检查发现的异常植物物质可通过提供异物大小和形状的信息,有助于规划和指导手术清除。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc61/5310010/2d7128d0ec66/13028_2017_280_Fig1_HTML.jpg

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