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绝育雄性犬双侧会阴疝并发空肠绞窄和嵌闭。

Jejunal strangulation and incarceration associated with bilateral perineal hernias in a neutered male dog.

机构信息

Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA.

Department of Veterinary Biosciences and Diagnostic Imaging, College of Veterinary Medicine, University of Georgia, Athens, GA.

出版信息

J Am Vet Med Assoc. 2021 Nov 12;260(1):110-114. doi: 10.2460/javma.20.11.0627.

DOI:10.2460/javma.20.11.0627
PMID:34780351
Abstract

CASE DESCRIPTION

An 8-year-old 6.8-kg neutered male Dachshund was presented for evaluation of vomiting, diarrhea, anorexia, and swelling over the right perineal region. The dog had a history of a bilateral perineal herniorrhaphy and castration 14 months prior to presentation.

CLINICAL FINDINGS

Bilateral perineal hernias were confirmed by digital rectal examination. Abdominal ultrasonography confirmed the presence of intestine within the right hernia. Three days after admission to the hospital, the region of the right perineal hernia became painful, erythematous, and edematous. Computed tomography revealed jejunal incarceration within the right hernia with dilation of 1 jejunal segment that indicated intestinal obstruction.

TREATMENT AND OUTCOME

Abdominal exploratory surgery was performed, during which irreducible small intestinal incarceration was confirmed. Intra-abdominal jejunal resection and anastomosis was performed, and an approximately 13-cm-long section of the jejunum was resected. Bilateral perineal herniorrhaphies with internal obturator and superficial gluteal muscle transposition were performed. Six months after surgery, digital rectal examination of the dog revealed that the repair was intact. The dog had no perineal hernia-related clinical signs at the time of the recheck examination.

CLINICAL RELEVANCE

For the dog of the present report, surgical management of small intestinal strangulation associated with a perineal hernia was successful. Although a portion of the small intestines can frequently be found within perineal hernias in dogs, perineal hernia-related small intestinal strangulation has not been previously described, to the authors' knowledge. Veterinarians and clients should be aware of this potential complication secondary to perineal hernia and be prepared to perform an abdominal surgical procedure to address small intestinal incarceration in affected dogs.

摘要

病例描述

一只 8 岁、6.8 公斤重的已绝育雄性达克斯猎犬前来就诊,表现为呕吐、腹泻、厌食和会阴部右侧肿胀。该犬在就诊前 14 个月曾行双侧会阴疝修补术和去势术。

临床发现

通过直肠指诊确认存在双侧会阴疝。腹部超声检查证实右侧疝内存在肠管。入院后 3 天,右侧会阴疝区域出现疼痛、红斑和水肿。计算机断层扫描显示空肠嵌顿于右侧疝内,1 个肠段扩张,提示肠梗阻。

治疗和预后

进行了腹部探查手术,术中确认存在不可复位的小肠嵌顿。进行了腹腔内空肠切除术和吻合术,切除了约 13cm 长的空肠段。行了双侧会阴疝修补术,采用内收肌和臀浅肌转位术。术后 6 个月,对犬进行直肠指诊显示修复完好。在复查时,该犬没有与会阴疝相关的临床症状。

临床意义

对于本报告中的犬,与会阴疝相关的小肠绞窄的手术治疗取得了成功。尽管在犬的会阴疝中经常可以发现一部分小肠,但据作者所知,以前没有描述过与会阴疝相关的小肠绞窄。兽医和宠物主人应该意识到这种与会阴疝相关的潜在并发症,并准备好对受影响的犬进行腹部手术以解决小肠嵌顿问题。

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