腔内小型肠梗阻的临床表现、检查结果和治疗效果-110 例成年牛回顾性研究。

Clinical presentation, investigation findings, and treatment outcomes of intraluminal small intestinal obstruction by bezoars and other materials in adult cows- a retrospective study of 110 cases.

机构信息

Department of Farm Animals, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zurich, CH-8057, Switzerland.

Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zurich, CH-8057, Switzerland.

出版信息

BMC Vet Res. 2024 Nov 21;20(1):525. doi: 10.1186/s12917-024-04379-z.

DOI:10.1186/s12917-024-04379-z

PMID:39574060

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11580191/

Abstract

BACKGROUND

Small intestinal obstruction (SIO) is a blockage of the intestinal lumen by blunt foreign bodies, neoplasms originating from the intestinal wall or thick chyme. This study analysed the medical records (only data) of 110 cattle with SIO and described the clinical findings, treatment and outcome. These findings were compared between surviving and non-surviving cattle, and among the affected regions such as the duodenum, jejunum and ileum.

RESULTS

Colic occurred in 42.7% (47/110) of the cattle. Rumen motility was absent in all cattle and intestinal motility was reduced or absent in 82.6% (90/109). Ballottement and/or percussion and simultaneous auscultation were positive on the right side in 63.3% (69/109). Little or no faeces in the rectum occurred in 93.6% (102/109) of the cattle. Dilated loops of small intestines could be palpated transrectally in 46.8% (51/109) and the actual obstruction (palpated as a firm mass in the small intestine) in 5.5% (6/109) of the cattle. The main laboratory changes were hypokalaemia (80.9%, 89/110), hypermagnesaemia (75.3% 58/77), hypocalcaemia (71.8%, 56/78), haemoconcentration (66.4%, 73/110), azotaemia (66.4%, 73/110) and positive base excess (63.3%, 62/98). Abnormal ultrasonographic findings included dilated loops of small intestines (94.3%, 83/88) and subjectively reduced or absent small intestinal motility (85.4%, 70/82). The actual obstruction could be visualised in 3.4% (3/89) of the cattle by ultrasonography. In the 14 non-surviving and the 96 surviving cattle the frequencies of abdominal dilatation (57.1%, 8/14 vs. 22.1%, 21/95) and the presence of blood, mucus and/or fibrin in the rectum (92.9%, 13/14 vs. 63.2%, 60/95) were significantly different. Abomasal reflux syndrome was significantly worse in the cattle with duodenal obstruction (26/110) than in those with jejunal (51/110) or ileal obstruction (33/110). A total of 107 cattle underwent right flank laparotomy, and the obstruction was resolved by massaging the affected area or it was removed via enterotomy. Of the 110 cattle, 14 (12.7%) were euthanized and 96 (87.3%) were discharged 3 to 10 days after surgery.

CONCLUSIONS

Transrectal and/or ultrasonographic diagnosis is the exception, and in almost all cases laparotomy, was required. The prognosis is good provided that surgical treatment is carried out promptly.

摘要

背景

小肠梗阻（SIO）是由钝性异物、源自肠壁或浓稠食糜的肿瘤引起的肠腔阻塞。本研究分析了 110 例 SIO 牛的病历（仅数据），并描述了临床发现、治疗和结果。将存活和非存活牛以及受影响的区域（如十二指肠、空肠和回肠）进行了比较。

结果

42.7%（47/110）的牛出现腹痛。所有牛的瘤胃蠕动均消失，82.6%（90/109）的牛肠蠕动减少或消失。右侧球囊冲击和/或叩诊与同时听诊阳性率为 63.3%（69/109）。93.6%（102/109）的牛直肠内几乎没有粪便。46.8%（51/109）可经直肠触诊到扩张的小肠环，5.5%（6/109）可触诊到实际梗阻（在小肠中触诊为坚硬肿块）。主要实验室变化包括低钾血症（80.9%，89/110）、高镁血症（75.3%，58/77）、低钙血症（71.8%，56/78）、血液浓缩（66.4%，73/110）、氮血症（66.4%，73/110）和正碱剩余（63.3%，62/98）。异常的超声发现包括扩张的小肠环（94.3%，83/88）和主观上的小肠蠕动减少或消失（85.4%，70/82）。在 89 头牛中，超声检查可显示出 3.4%（3/89）的实际梗阻。在 14 头非存活牛和 96 头存活牛中，腹部膨胀（57.1%，8/14 vs. 22.1%，21/95）和直肠中血液、黏液和/或纤维蛋白的存在（92.9%，13/14 vs. 63.2%，60/95）差异有统计学意义。与空肠和回肠梗阻（51/110、33/110）相比，十二指肠梗阻（26/110）的牛发生皱胃反流综合征的频率明显更高。107 头牛接受了右侧肋部剖腹手术，通过按摩受影响的区域或通过肠切开术解决了梗阻。110 头牛中，14 头（12.7%）被安乐死，96 头（87.3%）在手术后 3 至 10 天出院。