Department of Clinical Science and Services, Queen Mother Hospital for Animals, The Royal Veterinary College, London, UK.
Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, Tennessee, USA.
J Vet Intern Med. 2020 Mar;34(2):684-690. doi: 10.1111/jvim.15731. Epub 2020 Feb 18.
Ileoscopy is increasingly performed in dogs and cats with gastrointestinal signs, but iatrogenic ileocecocolic (ICC) perforations have not been described.
HYPOTHESIS/OBJECTIVES: To characterize endoscopic ICC perforations in dogs and cats.
Thirteen dogs and 2 cats.
This is a retrospective case series. Signalment, presentation, endoscopic equipment, colonic preparation, endoscopist's experience level, ileal intubation technique, method of diagnosis, perforation location, histopathology, management, and outcome data were collected and reviewed.
Six ileal, 5 cecal, and 4 colonic perforations were identified between 2012 and 2019. Dogs weighed 2.4-26 kg (median, 10.3 kg) and cats 4.6-5.1 kg (median, 4.9 kg). Endoscopy was performed in dogs presented for vomiting (n = 4), as well as large (n = 5), mixed (n = 4), and small (n = 1) bowel diarrhea. Cats had large bowel diarrhea. Endoscopists included 1 supervised intern, 9 supervised internal medicine residents (2 first year, 6 second year, 1 third year), and 5 internal medicine diplomates. Diagnosis was delayed in 5 dogs, occurring 1-5 days after endoscopy (median, 3 days); dogs were presented again with inappetence (n = 4), lethargy (n = 4), abdominal pain (n = 3), retching (n = 2), and syncope (n = 1). All animals underwent surgical correction. Histopathology did not identify lesions at the perforation site in any animal. Two dogs required a second surgery; 1 died 12 hours after surgery. Survival to discharge was 93%, with 78% surviving ≥8 months.
Iatrogenic endoscopic ICC perforation is not indicative of underlying disease and is associated with a good prognosis. Delayed diagnosis can occur. Therefore, perforation should be considered in the differential diagnosis for animals with clinical deterioration after endoscopy.
越来越多的犬猫出现胃肠道症状时会进行小肠镜检查，但尚未描述医源性回盲肠（ICC）穿孔。
假设/目的：描述犬猫内镜下 ICC 穿孔的特征。
13 只狗和 2 只猫。
这是一项回顾性病例系列研究。收集并回顾了一般信息、临床表现、内镜设备、结肠准备、内镜医师经验水平、回肠插管技术、诊断方法、穿孔位置、组织病理学、治疗方法和预后数据。
2012 年至 2019 年期间共发现 6 例回肠、5 例盲肠和 4 例结肠穿孔。狗的体重为 2.4-26kg（中位数为 10.3kg），猫的体重为 4.6-5.1kg（中位数为 4.9kg）。行小肠镜检查的狗表现为呕吐（n=4），以及大便量多（n=5）、混合（n=4）和大便量少（n=1）。猫则出现大便量多。内镜医师包括 1 名实习医生、9 名实习内科住院医师（2 年级 1 名、3 年级 6 名）和 5 名内科专科医生。5 只狗的诊断延迟，在小肠镜检查后 1-5 天（中位数 3 天）出现；这些狗再次出现食欲不振（n=4）、嗜睡（n=4）、腹痛（n=3）、干呕（n=2）和晕厥（n=1）。所有动物均接受了手术治疗。任何动物的穿孔部位组织病理学均未发现病变。2 只狗需要再次手术；1 只狗在手术后 12 小时死亡。出院存活率为 93%，8 个月以上存活率为 78%。
内镜下 ICC 穿孔不是潜在疾病的指标，预后良好。可能出现延迟诊断。因此，内镜检查后出现临床恶化的动物，应考虑穿孔作为鉴别诊断。
