García-Pertierra Sofia, Gonzàlez-Gasch Esteban, Catalá Puyol Carmen, Closa Boixeda Jose María
Hospital Ars Veterinaria, Barcelona, Spain.
JFMS Open Rep. 2017 Aug 18;3(2):2055116917725222. doi: 10.1177/2055116917725222. eCollection 2017 Jul-Dec.
A 5-year-old male neutered domestic shorthair cat was presented to our referral centre with a 13 month history of chronic tenesmus due to malunion of the right caudal iliac body. Constipation and pelvic canal stenosis were initially addressed by the referring veterinarian with a right femoral head and neck excision and a right acetabulectomy without observable clinical improvement. At admission, abdominal radiographs revealed severe colonic distension and a narrowed pelvic canal caused by the right proximal femur. Rectal examination and colonography revealed a dynamic compression of the rectum, which worsened with femoral abduction and improved with femoral adduction. A right hindlimb amputation was performed to relieve the obstruction. The cat defaecated 2 days postoperatively and was discharged uneventfully. Neither faecal tenesmus nor dyschaezia were observed over the following 10 months.
The dynamic nature of the rectal obstruction most likely prevented the development of an irreversible colonic dilatation leading to a megacolon. This is the first report describing a chronic dynamic rectal compression, which was successfully managed with a right hindlimb amputation without the need for subtotal colectomy.
一只5岁已绝育的雄性家养短毛猫被送至我们的转诊中心,因右尾侧髂骨体畸形愈合,有13个月慢性里急后重病史。转诊兽医最初通过右侧股骨头和颈切除术及右侧髋臼切除术处理便秘和盆腔管狭窄,但未见明显临床改善。入院时,腹部X光片显示严重的结肠扩张以及由右股骨近端导致的盆腔管狭窄。直肠检查和结肠造影显示直肠存在动态压迫,股骨外展时加重,股骨内收时改善。进行了右后肢截肢以解除梗阻。这只猫术后2天排便,顺利出院。在接下来的10个月里,未观察到粪便里急后重或排便困难。
直肠梗阻的动态性质很可能阻止了不可逆的结肠扩张发展为巨结肠。这是第一份描述慢性动态直肠压迫的报告,通过右后肢截肢成功处理,无需进行结肠次全切除术。