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牛因外部疝出导致的小肠嵌顿可通过临床诊断,但需要剖腹手术来确认内部嵌顿。

Small intestinal incarceration caused by external herniation can be diagnosed clinically in cattle, but laparotomy is required to confirm internal incarceration.

作者信息

Braun Ueli, Gerspach Christian, Bennien Elena, Hilbe Monika, Nuss Karl

机构信息

1Department of Farm Animals, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zurich, Switzerland.

2Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zurich, Switzerland.

出版信息

J Am Vet Med Assoc. 2024 Oct 18;263(1):71-81. doi: 10.2460/javma.24.01.0002. Print 2025 Jan 1.

DOI:10.2460/javma.24.01.0002
PMID:39426401
Abstract

OBJECTIVE

To describe the clinical, laboratory and ultrasonographic findings, treatment, and outcome of cattle with small intestinal incarceration (SII) through internal and external hernias.

METHODS

The medical records of 85 cattle with SII admitted between January 1, 1987, and December 31, 2019, were retrospectively reviewed. The long-term outcome was determined 2 years after discharge.

RESULTS

85 cattle had herniation of the small intestine through congenital or acquired openings in mesentery or omentum (internal herniation; n = 60) or the abdominal wall (external herniation; 25). The most common findings were little or no feces in the rectum (77 of 85 [90.6%]), reduced or absent intestinal motility (76 of 85 [89.4%]), and hypocalcemia (36 of 44 [81.8%]). Thirteen (15.3%) cattle died or were euthanized without surgery. Of the remaining 72 (84.7%) cattle that underwent surgery, 42 survived the procedure. Overall, 52 of 85 cattle (61.2%; 95% CI, 50% to 72%) did not survive to hospital discharge and 33 (38.8%; 95% CI, 28% to 50%) were discharged alive. Of these, 11 (33.3%; 6 with and 5 without hernias closed completely) were still productive in their respective herds 2 years later.

CONCLUSIONS

The diagnosis of an incarcerated external hernia is usually straightforward, whereas internal SII necessitates laparotomy or postmortem examination for a definitive diagnosis.

CLINICAL RELEVANCE

Internal herniation should be part of the differential diagnosis in cattle with signs of ileus. Immediate surgical treatment is paramount in cattle with SII.

摘要

目的

描述通过内疝和外疝发生小肠嵌顿(SII)的牛的临床、实验室及超声检查结果、治疗方法及预后情况。

方法

对1987年1月1日至2019年12月31日期间收治的85例SII牛的病历进行回顾性分析。出院2年后确定长期预后情况。

结果

85头牛通过肠系膜或网膜的先天性或后天性开口(内疝;n = 60)或腹壁(外疝;25)发生小肠疝。最常见的表现为直肠内粪便很少或无粪便(85例中的77例[90.6%])、肠动力减弱或消失(85例中的76例[89.4%])以及低钙血症(44例中的36例[81.8%])。13头(15.3%)牛未手术即死亡或实施安乐死。其余72头(84.7%)接受手术的牛中,42头手术存活。总体而言,85头牛中有52头(61.2%;95%可信区间,50%至72%)未存活至出院,33头(38.8%;95%可信区间,28%至50%)存活出院。其中,11头(33.3%;6头疝完全闭合,5头未完全闭合)在2年后仍在各自牛群中正常生产。

结论

嵌顿性外疝的诊断通常较为直接,而内疝型SII则需要剖腹探查或尸体剖检才能明确诊断。

临床意义

内疝应作为肠梗阻症状牛的鉴别诊断之一。对于SII牛,立即进行手术治疗至关重要。

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