Van Heerden Frans G, Hartman Marthinus J, McClure Vanessa, Kirberger Robert M
Department of Companion Animal Clinical Studies, University of Pretoria.
J S Afr Vet Assoc. 2018 Nov 6;89(0):e1-e5. doi: 10.4102/jsava.v89i0.1713.
A 12-year-old spayed Newfoundland bitch was presented with chronic non-productive vomiting, regurgitation and coughing of six weeks' duration. On clinical examination, the dog was depressed with no other significant findings. Haematology and biochemistry investigations detected no abnormalities. Thoracic and abdominal radiographs revealed a megaoesophagus and an abnormally positioned pylorus. A thoracic and abdominal computed tomography scan confirmed the abnormal position of the stomach, together with moderate aspiration pneumonia. Laparoscopic examination of the peritoneal cavity revealed the greater omentum wrapped over the stomach, with a fold visualised between the abnormally positioned pyloric antrum and the gastric corpus. A 180-degree clockwise gastric rotation was laparoscopically diagnosed and corrected. The normal position of the stomach was confirmed before a laparoscopic-assisted incisional gastropexy was performed. Post-operatively the vomiting and regurgitation resolved and the patient was discharged. Twenty-four hours after discharge, the dog was presented with deteriorating clinical signs of aspiration pneumonia. The owner declined treatment, additional diagnostics as well as a necropsy and requested euthanasia. Chronic gastric volvulus should be considered as a rare differential diagnosis in dogs with non-specific, chronic gastrointestinal signs. Radiography, computed tomography and laparoscopy are valuable diagnostic aids in making this diagnosis. Chronic gastric volvulus can be successfully reduced laparoscopically as reported here for the first time.
一只12岁已绝育的纽芬兰母犬出现持续六周的慢性无 productive呕吐、反流和咳嗽。临床检查时,该犬精神沉郁,无其他明显异常。血液学和生物化学检查未发现异常。胸部和腹部X光片显示食管扩张和幽门位置异常。胸部和腹部计算机断层扫描证实了胃的异常位置,同时伴有中度吸入性肺炎。腹腔镜检查腹腔发现大网膜包裹在胃上,在异常位置的幽门窦和胃体之间可见一个褶皱。经腹腔镜诊断并纠正了胃顺时针旋转180度的情况。在进行腹腔镜辅助切口胃固定术之前确认了胃的正常位置。术后呕吐和反流症状消失,病犬出院。出院24小时后,该犬出现吸入性肺炎病情恶化的临床症状。主人拒绝治疗、进一步诊断以及尸体剖检,并要求实施安乐死。对于有非特异性慢性胃肠道症状的犬,慢性胃扭转应被视为一种罕见的鉴别诊断。X光检查、计算机断层扫描和腹腔镜检查是做出该诊断的有价值的诊断辅助手段。如本文首次报道,慢性胃扭转可通过腹腔镜成功复位。