Tobias K M
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Ohio State University, Columbus 43210.
J Am Vet Med Assoc. 1994 Nov 1;205(9):1292-6.
This report describes the management of rectal perforation, incision infection, implant failure, sepsis, osteonecrosis, and enterocutaneous fistula formation in a 3-year-old Yorkshire Terrier that was hit by a car. Rectal perforation from displaced pelvic fractures was suspected because of drainage from the incision, and clinical signs, and blood test results indicative of sepsis. Ilial and acetabular osteonecrosis from wound infection were treated with hemipelvectomy without pelvic limb amputation, and full limb function was regained. Primary repair of the rectal perforation and use of a muscle flap were unsuccessful, and a rectocutaneous fistula developed, but the rectum healed after colostomy for fecal diversion. An enterocutaneous fistula subsequently developed at the rectocutaneous fistula site, resulting in weight loss and continued drainage from the incision. Primary closure of the jejunal stoma, appropriate wound management, and nutritional support by enteral feeding resulted in eventual second-intention healing of the fistula and incision.
本报告描述了一只3岁的约克夏梗犬被车撞后直肠穿孔、切口感染、植入物失败、败血症、骨坏死和肠皮肤瘘形成的治疗情况。因切口有引流物、临床症状及血液检查结果提示败血症，怀疑因骨盆骨折移位导致直肠穿孔。伤口感染引起的髂骨和髋臼骨坏死采用半骨盆切除术治疗，未行骨盆肢体截肢，肢体功能完全恢复。直肠穿孔的一期修复及肌瓣的使用均未成功，形成了直肠皮肤瘘，但在进行结肠造口术以改道粪便后直肠愈合。随后在直肠皮肤瘘部位出现肠皮肤瘘，导致体重减轻且切口持续有引流物。空肠造口的一期闭合、适当的伤口处理以及通过肠内喂养进行营养支持，最终使瘘管和切口实现二期愈合。
