Department of Farm Animals, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
Acta Vet Scand. 2024 Apr 15;66(1):17. doi: 10.1186/s13028-024-00738-w.
Torsion of the spiral colon (TSC) describes twisting of the spiral colon around its mesentery. The present study reviewed the medical records of 58 cows and heifers with TSC and described the findings, treatment and outcome.
All cases had an abnormal general condition, and the main vital sign abnormalities were tachycardia (72.4%), tachypnoea (67.2%) and decreased rectal temperature (51.8%). Signs of colic were seen in 62.1% of the cows. The most common intestinal abnormalities were an empty or almost empty rectum (96.6%), reduced or absent rumen motility (93.2%), positive ballottement and/or percussion and simultaneous auscultation on the right side of the abdomen (87.9%), reduced or absent intestinal motility (84.5%) and dilatation of the large intestines (spiral colon and/or caecum, 70.7%) diagnosed by transrectal palpation. The main biochemical changes were hypermagnesaemia (70.8%), hypocalcaemia (70.8%), and acidosis (66.7%). Haemoconcentration was found in 63.8%. The main ultrasonographic findings were reduced to absent small intestinal motility (83.3%), dilated small intestines (69.6%) and ascites (66.7%). The spiral colon was dilated in 44.0% of the cows and the caecum in 24.0%. The actual site of torsion could not be visualised. Based on the clinical findings, TSC was diagnosed in 22.4% and caecal dilatation in 50.0% of the cows. A tentative diagnosis of small intestinal ileus was made in another 10.3% of the cows, and a definitive diagnosis of small intestinal ileus in 17.3%. Fifty-three cows underwent right flank laparotomy, and the TSC could be reduced in 26. Twenty-six of the 58 (44.8%) cows were discharged and 32 (55.2%) were euthanased before, during or after surgery.
Acute illness, a sparse amount of faeces in the rectum and dilated spiral colon and caecum are characteristic findings of TSC. The final diagnosis often relies on the surgical or postmortem findings. Cattle with TSC should be treated surgically without delay. The prognosis is guarded with a survival rate of 44.8%.
螺旋结肠扭转（TSC）描述了螺旋结肠围绕其肠系膜的扭转。本研究回顾了 58 头奶牛和小母牛的 TSC 病历，并描述了发现、治疗和结果。
所有病例均有异常一般情况，主要生命体征异常为心动过速（72.4%）、呼吸急促（67.2%）和直肠温度降低（51.8%）。62.1%的奶牛出现腹痛体征。最常见的肠道异常包括直肠排空或几乎排空（96.6%）、瘤胃蠕动减少或消失（93.2%）、右侧腹部球囊感和/或叩诊阳性和同时听诊（87.9%）、肠蠕动减少或消失（84.5%）和大肠扩张（螺旋结肠和/或盲肠，70.7%）通过直肠触诊诊断。主要生化变化为高镁血症（70.8%）、低钙血症（70.8%）和酸中毒（66.7%）。发现血浓缩占 63.8%。主要的超声表现为小肠蠕动减少或消失（83.3%）、小肠扩张（69.6%）和腹水（66.7%）。44.0%的奶牛螺旋结肠扩张，24.0%的盲肠扩张。实际扭转部位无法可视化。根据临床发现，22.4%的奶牛被诊断为 TSC，50.0%的奶牛被诊断为盲肠扩张。另有 10.3%的奶牛被怀疑为小肠性肠梗阻，17.3%的奶牛被确诊为小肠性肠梗阻。53 头奶牛行右侧侧腹切开术，26 头奶牛 TSC 可复位。58 头（44.8%）奶牛中有 26 头出院，32 头（55.2%）在手术期间或手术后被安乐死。
急性疾病、直肠内粪便稀少和扩张的螺旋结肠和盲肠是 TSC 的特征性发现。最终诊断通常依赖于手术或尸检结果。患有 TSC 的牛应立即进行手术治疗。预后不佳，存活率为 44.8%。
