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牛十二指肠乙状弯曲梗阻的十二指肠十二指肠吻合术

Duodenoduodenostomy for obstruction of the sigmoid flexure of the duodenum in cattle.

作者信息

Hackett Eileen S, Lang Hayley M, Desrochers Andre, Nichols Sylvain, Fubini Susan Lawson

机构信息

Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado.

Department of Clinical Sciences, Cornell University, Ithaca, New York.

出版信息

Vet Surg. 2018 Jul;47(5):623-628. doi: 10.1111/vsu.12901. Epub 2018 May 15.

Abstract

OBJECTIVE

To describe clinical findings, surgical treatment, and outcome associated with duodenoduodenostomy for treatment of duodenal obstruction secondary to adhesions associated with the sigmoid flexure of the duodenum.

STUDY DESIGN

Retrospective study (1996-2016).

ANIMALS

Fourteen Holstein cattle.

METHODS

Medical records of cows treated at 3 academic surgical referral centers with duodenoduodenostomy for duodenal obstruction secondary to adhesions associated with the sigmoid flexure of the duodenum were reviewed. Data that were collected included signalment, physical examination results, laboratory results, diagnostic findings, treatments, and survival to discharge. Owners were contacted for follow-up information.

RESULTS

Affected cattle ranged in age from 4 months to 5 years. Electrolyte abnormalities, including severe hypochloremia, were present in all cases. Abnormalities included cranial duodenal distension without concurrent distension of the descending duodenum and palpable focal adhesions in the region of the sigmoid flexure of the duodenum. Duodenoduodenostomy involved a stapled (n = 11) or sutured (n = 3) side-to-side anastomosis between the cranial duodenum and descending duodenum. Thirteen of 14 cattle that were treated with duodenoduodenostomy survived to hospital discharge. Long-term follow-up was available in 8 cows, and 7 of those 8 survived for at least 1 year.

CONCLUSION

Short- and long-term survival were favorable after duodenoduodenostomy in cattle with adhesions associated with the sigmoid flexure of the duodenum.

CLINICAL SIGNIFICANCE

Duodenoduodenostomy results in acceptable survival and future productivity in cows with obstruction at the sigmoid flexure of the duodenum.

摘要

目的

描述十二指肠十二指肠吻合术治疗因十二指肠乙状弯曲粘连继发十二指肠梗阻的临床症状、手术治疗及预后。

研究设计

回顾性研究(1996 - 2016年)。

动物

14头荷斯坦奶牛。

方法

回顾了3个学术性外科转诊中心对因十二指肠乙状弯曲粘连继发十二指肠梗阻而行十二指肠十二指肠吻合术治疗的奶牛的病历。收集的数据包括特征、体格检查结果、实验室检查结果、诊断结果、治疗方法及出院存活率。与畜主联系以获取随访信息。

结果

患病奶牛年龄从4个月至5岁不等。所有病例均存在电解质异常,包括严重低氯血症。异常表现为十二指肠近端扩张而十二指肠降段无同时扩张,且在十二指肠乙状弯曲区域可触及局灶性粘连。十二指肠十二指肠吻合术包括在十二指肠近端和降段之间进行吻合器吻合(n = 11)或缝合吻合(n = 3)。接受十二指肠十二指肠吻合术治疗的14头奶牛中有13头存活至出院。8头奶牛有长期随访资料,其中7头存活至少1年。

结论

对于因十二指肠乙状弯曲粘连的奶牛,十二指肠十二指肠吻合术后短期和长期存活率良好。

临床意义

十二指肠十二指肠吻合术可使十二指肠乙状弯曲梗阻奶牛获得可接受的存活率及未来生产力。

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