Département de sciences cliniques, Faculté de médecine vétérinaire, Université de Montréal, Montreal, Québec, Canada.
Department of Veterinary Clinical Sciences, Ohio State University, Columbus, Ohio, USA.
J Vet Intern Med. 2022 Sep;36(5):1677-1685. doi: 10.1111/jvim.16511. Epub 2022 Aug 17.
Placement of a subcutaneous ureteral bypass (SUB) device is an effective method to relieve all causes of ureteral obstruction in cats. Complications involving migration within the gastrointestinal tract have been seldomly described.
To characterize transmural migration of SUB devices within the digestive tract in cats.
Eleven migrated SUB catheters identified in 8 cats between 2017 and 2021.
Retrospective review of medical records of cats with a SUB device in which migration into the gastrointestinal tract was identified.
The median time from SUB device placement to implant migration was 928 days (201-2298 days). Seven cats had obstruction of the SUB device and a positive urine culture at diagnosis. The migration was identified by ultrasound in 6/11, pre-operative contrast radiography in 2/2, and only at time of surgery in 3 SUB devices. All cats underwent surgical correction. Four nephrostomy and 7 cystotomy catheters migrated. Migration occurred into the duodenum (3/11), jejunum (7/11), and colon (1/11). SUB devices were removed in 7 cats and replaced in 2 cats, with 1 cat diagnosed with 2 migration events. Gastrointestinal resection and anastomosis were performed in 7/8 cats and an enterotomy in 2 cats. Six cats survived to discharge. The median follow-up time after migration diagnosis was 365 days (range, 0-1114 days) and 2 cats are still alive.
Although a rare complication, migration of SUB device should be considered in cats with SUB device obstruction and a positive urine culture.
皮下输尿管旁路（SUB）装置的放置是缓解猫所有原因引起的输尿管梗阻的有效方法。涉及胃肠道内迁移的并发症很少有描述。
描述猫 SUB 装置在消化道内的穿壁迁移。
2017 年至 2021 年间，在 8 只猫中发现了 11 个迁移的 SUB 导管。
回顾性分析有 SUB 装置且迁移到胃肠道的猫的病历。
从 SUB 装置放置到植入物迁移的中位时间为 928 天（201-2298 天）。7 只猫在诊断时 SUB 装置阻塞且尿液培养阳性。6/11 例通过超声、2/2 例通过术前对比放射摄影术、3 例仅在手术时发现 SUB 装置迁移。所有猫均接受手术矫正。4 个肾造口术和 7 个膀胱造口术导管迁移。迁移发生在十二指肠（3/11）、空肠（7/11）和结肠（1/11）。7 只猫中 SUB 装置被取出，2 只猫中 SUB 装置被替换，1 只猫诊断为 2 次迁移。7/8 只猫进行了胃肠道切除术和吻合术，2 只猫进行了肠切开术。6 只猫存活至出院。迁移诊断后中位随访时间为 365 天（范围，0-1114 天），2 只猫仍存活。
尽管 SUB 装置迁移是一种罕见的并发症，但在 SUB 装置阻塞和尿液培养阳性的猫中应考虑 SUB 装置迁移。
