Reimer J M, Donawick W J, Reef V B, Wagner H R, Divers T J
Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Kennett Square 19348.
J Am Vet Med Assoc. 1988 Dec 15;193(12):1539-41.
Patent ductus venosus was diagnosed in a 10-week-old Holstein heifer with acute onset of collapse and marked tenesmus. Additional clinical signs observed during the course of hospitalization included depression, anorexia, hind limb ataxia, bruxism, and poor growth. Clinicopathologic test results included high blood ammonia concentration, prolonged sulfobromophthalein half-life, and high serum bile acid concentration. Liver biopsy revealed mild periportal fibrosis, but no appreciable hepatocyte atrophy. Mesenteric portography and percutaneous ultrasonography confirmed the patent ductus venosus. An atrial septal defect prosthesis was placed in the ductus venosus, using a catheterization technique. After surgery, however, clinicopathologic test results were unchanged. Ultrasonography revealed that the prosthesis had pulled away from one side of the vessel. When the calf was 10.5 months old, surgical correction was achieved by a transhepatic ligation technique. Ultrasonography confirmed closure of the ductus venosus during and after surgery. Blood ammonia and serum bile acid concentrations and sulfobromophthalein half-life were normal 3 weeks after surgery. The calf had no further episodes of hepatoencephalopathy and was successfully bred at 18 months of age.
一头10周龄的荷斯坦小母牛被诊断为静脉导管未闭，伴有急性虚脱和明显的里急后重。住院期间观察到的其他临床症状包括抑郁、厌食、后肢共济失调、磨牙症和生长发育不良。临床病理检查结果包括血氨浓度升高、磺溴酞钠半衰期延长和血清胆汁酸浓度升高。肝脏活检显示轻度门静脉周围纤维化，但无明显肝细胞萎缩。肠系膜门静脉造影和经皮超声检查证实静脉导管未闭。采用导管技术在静脉导管中放置了房间隔缺损封堵器。然而，手术后临床病理检查结果未改变。超声检查显示封堵器已从血管一侧脱落。当这头小牛10.5月龄时，通过经肝结扎技术实现了手术矫正。超声检查证实手术期间及术后静脉导管已闭合。术后3周血氨、血清胆汁酸浓度及磺溴酞钠半衰期均正常。这头小牛未再发生肝性脑病，并在18月龄时成功配种。
