Intestinal atresia and stenosis: a review comparing its etiopathogenesis

Two theories were proposed originally to describe the development of congenital intestinal atresia. The theory of imperfect recanalization, the theory of vascular insufficiency, and studies which have been performed to validate each of these theories were reviewed. Specific causes of the development of vascular insufficiencies in different species were reviewed if literature was available. In utero vascular accidents have been incriminated as the major cause of congenital intestinal atresia distal to the duodenum. There was relatively little evidence to show that intestinal atresia is inherited in any species. Duodenal atresia may be caused by either an embryologic defect for which there is some evidence of inheritance or by a vascular accident. The pathogenic mechanism for intestinal atresia may be similar in most species.     

Clinical management and surgical repair of atresia coli in calves: 66 cases (1977-1988).

The medical records of 66 calves with atresia coli were reviewed; 64 calves were examined at the New York State College of Veterinary Medicine, and 2 calves were examined at the New Bolton Center. In each case, the site of the atresia was within the spiral loop of the ascending colon. In 1 of these calves, a segment of jejunum was also atretic. Absence of feces, progressive weakness, and abdominal distension were the most common clinical signs observed. Other congenital abnormalities were detected in 12 (18%) of 66 calves. Of the 66 calves examined, 5 were euthanatized or died on admission, and 61 had an exploratory celiotomy performed. Eight calves were euthanatized or died during the surgery. In the remaining 53 calves, surgical treatment consisted of enterotomy followed by meconium evacuation, resection of the proximal blind end (in 30 calves), and restoration of intestinal continuity. Restoration of intestinal continuity was done either by side-to-side anastomosis of the proximal to distal blind ends (5 calves), or by side-to-side or end-to-side anastomosis of the proximal blind end to the descending colon (48 calves). Of the 66 calves seen, 27 (41%) were discharged from the hospital, and 11 of these reached reproductive age (11 calves were lost to follow-up before they were 2 years old). From the 11 calves reaching reproductive age, 33 calves were born, one of which may have had atresia coli. The owners should anticipate that long-term survivors likely will have loose feces and normal offspring, but may not grow as well as otherwise expected.     

Intestinal atresia and stenosis: a review comparing its morphology

A review of the literature on intestinal atresia of domestic animal species and humans was done. The 5 types of intestinal occlusions described in human infants are atresia type 1, atresia type 2, atresia type 3, stenosis, and the "apple peel" or "Christmas tree" deformity. The intestinal defects described in domestic animal species such as the bovine, equine and porcine are similar to those of human infants. The "T-formation", an intestinal defect of the bovine resembling atresia type 3, and rectal stricture, an acquired intestinal defect of the porcine resembling stenosis, were described recently. Intestinal atresia is similar in several species and these similarities raise the questions as to whether the pathogenic mechanism and possibly etiologies of intestinal atresia are similar in these species.     

Atresia coli in a foal: Diagnosis made with colonoscopy aided by N‐butylscopolammonium bromide

Atresia coli, a rare congenital defect, was diagnosed in a foal via colonoscopy after N‐butylscopolammonium bromide was used to aid visualisation of the intestinal defect. Colonoscopy is a cost effective tool for diagnosing atresia of the terminal colon. N‐butylscopolammonium bromide aided colonoscopy has not been previously reported in horses.     

CONGENITAL ATRESIA OF THE PAROTID DUCT IN A HORSE

Congenital anomalies of the equine salivary glands and their ductal systems are rare. In man, parotid duct atresia is thought to be due to a congenital malformation of the first branchial arch. One horse with unilateral parotid salivary duct atresia is described. Imaging modalities available for accurate diagnosis, and treatment options, are reviewed.     

Rectal atresia in a newborn donkey

A case of a type I rectal atresia (also known as membranous rectal atresia) in a newborn donkey is reported. Clinical examination, survey radiographs and barium enema radiographs suggested rectal atresia. An exploratory laparotomy was performed; however, surgical correction of the defect was not possible due to the narrow pelvic cavity. Euthanasia was performed. At necropsy, it was possible to observe a fibrous cord connecting the small colon to a residual rectal ampulla, which opened to a normal anus. The radiographic and anatomical characteristics enabled the classification of the defect as type I rectal atresia, which is a rare congenital anomaly that is difficult to correct through surgery. This report contributes to the study of rectal atresia in newborn equids, alerts for the occurrence in donkeys and is, to our knowledge, the first to be reported in this species in Brazil.     

颗粒细胞凋亡影响家禽卵泡闭锁的研究进展

卵巢是家禽的重要繁殖器官,会产生大量卵泡,而卵泡在生长发育的各个阶段中都可能因为不同因素的调控而发生闭锁,最终导致繁殖性能衰退。颗粒细胞对卵泡的生长发育有重要调控作用,其凋亡会诱导卵泡发生闭锁。诱导颗粒细胞发生凋亡的因素较多,包括激素、细胞因子、氧化应激、线粒体及其他体外因素。颗粒细胞凋亡主要由线粒体途径导致,其涉及到半胱天冬酶（Caspase）家族参与,当线粒体裂解时会释放细胞色素C （Cyt-C）,随后形成凋亡小体激活Caspase-3和Caspase-8,最终激活Caspase-9导致颗粒细胞凋亡;当颗粒细胞发生凋亡,家禽体内卵泡丧失生物功能并且卵泡细胞之间的调控失衡,促使卵泡内卵母细胞和膜细胞凋亡,最终导致卵泡发生闭锁;颗粒细胞在存活状态下所分泌的生长因子、性腺类固醇、细胞因子能减少卵母细胞氧化损伤,防止细胞内活性氧（ROS）水平过高导致的线粒体DNA损伤,从而避免线粒体功能障碍而造成的颗粒细胞凋亡。作者从颗粒细胞凋亡及其影响因素、颗粒细胞凋亡和卵泡闭锁的关系、颗粒细胞凋亡对卵泡闭锁的影响3个方面进行阐述,以期为减少卵泡闭锁、提高家禽繁殖性能提供理论依据。     

Intestinal atresia and stenosis: A review comparing its morphology

A review of the literature on intestinal atresia of domestic animal species and humans was done. The 5 types of intestinal occlusions described in human infants are atresia type 1, atresia type 2, atresia type 3, stenosis, and the apple peel or Christmas tree deformity. The intestinal defects described in domestic animal species such as the bovine, equine and porcine are similar to those of human infants. The T-formation, an intestinal defect of the bovine resembling atresia type 3, and rectal stricture, an acquired intestinal defect of the porcine resembling stenosis, were described recently. Intestinal atresia is similar in several species and these similarities raise the questions as to whether the pathogenic mechanism and possibly etiologies of intestinal atresia are similar in these species.     

Perosomus elumbis, cerebral aplasia, and spina bifida in an aborted thoroughbred foal

Perosomus elumbis represents a rare congenital anomaly characterized by aplasia of the lumbosacral spinal cord and vertebrae. This anomaly is often associated with arthrogryposis and malformations of the urogenital and intestinal tract. This report describes the first case of perosomus elumbis in an aborted Thoroughbred foal associated with cerebral aplasia with meningocele, cranioschisis, spina bifida, a fused urogenital and intestinal tracts lined by a cutaneous mucosa without uterine glands, atresia ani, and arthrogryposis of the hind legs. Immunohistochemistry detected no abnormalities in the GFAP, S-100, vimentin, NeuN, doublecortin, and neurofilament expression pattern in the remnants of the brainstem. Pathogenic bacteria or equine herpesviruses one and four were not found using a microbiological investigation or polymerase chain reaction, respectively. The observed malformations may be induced by a severe developmental disturbance during the formation of the neural tube with secondary distortion of the surrounding mesoderm. Although the aetiology of this dysorganogenesis remains undetermined, inherited chromosomal mutations, an intake of different xenobiotics, and/or a disturbed metabolism of the mare may have caused the defect.     

Congenital tumours and tumour-like lesions in domestic animals. 3. Horses. A review

The literature on congenital tumours and tumour-like lesions in horses was reviewed. Included were embryonic tumours and teratomas. Special attention was paid to the ubiquitous adenomatous hyperplasia of the placenta. It appears that temporal teratomas, interstitial hamartomas and placental adenomatous hyperplasia are unique in the horse. Benign teratoma of the undescended testis is far more frequent in the horse than in other species. In horses, as in calves and pigs, congenital skin tumours were of papillomatous, vascular and melanocytic types. The sporadic occurrence of congenital tumours in the horse did not provide an etiologic or pathogenetic clue. The possibility of oncogenic viruses in cases of congenital skin papilloma or malignant lymphoma could neither be proven, nor be excluded. Hereditary tumours were not encountered.     

Epidemiological investigations of an outbreak of intestinal atresia in two Israeli dairy herds

An epidemiological investigation of an outbreak of intestinal atresia in Israeli Holstein-Friesian newborn calves showed a linkage with rectal palpation for early pregnancy diagnosis, performed less than 42 days after insemination. The odds of an exposed calf, i.e., one born to a dam that was diagnosed by early palpation as having intestinal atresia were 119.7 times higher than one born in normal control herds (95% CI; 7.4-1946.3). A total of 682 calves-at-risk was recorded from mid-1998 to mid-2000 and a total of 47 calves (6.9%) were born with intestinal atresia during this period. Two forms of intestinal atresia were recognized at post-mortem: atresia coli and atresia ilei.     

Surgical repair of atresia jejuni in two calves.

Two Holstein calves with similar histories of not defecating since birth were determined to have atresia jejuni. Resection of the distended blind end of the jejunum and the remaining jejunum and ileum followed by a jejunocecostomy was performed. One calf died 7 months after surgery of unknown causes. The second calf has survived for greater than 1 year, and has maintained a growth rate similar to other calves its age. Atresia jejuni has been reported to be a universally fatal disorder of unknown pathogenesis. It has been postulated that intestinal atresia is caused by palpation of the amniotic vesicle at the time of pregnancy diagnosis, between days 36 and 42 of gestation.     

Evidence for vascular and enzymatic events in the pathophysiology of acute laminitis: which pathway is responsible for initiation of this process in horses?

To date, there is a substantial amount of data to support the hypotheses that vascular and enzymatic changes are ongoing in experimental laminitis. Furthermore, there is substantial in vitro evidence that the enzymatic changes weaken the dermo-epidermal attachments leading to mechanical failure of the hoof-bone interface of the equine digit. However, investigators of both the vascular and enzymatic theories have, to date, been unable to substantiate the effects of these pathophysiological changes in vivo on laminar tissues of horses afflicted with experimentally induced or naturally acquired laminitis. In addition, the effects of laminitis-inducing treatment have not been prevented or reversed by treatment with an MMP inhibitor or a vasoactive antagonist. It is possible that there is simultaneous activation of the vascular and enzymatic pathways and/or other inflammatory processes. Moreover, the third theory involving mechanical factors cannot be discounted simply because strong evidence for vascular and enzymatic changes exists. It is common for horses with severe musculoskeletal disease affecting weightbearing on a limb to develop laminitis in the contralateral limb. It remains to be determined what factors are responsible for initiation of laminitis in these individuals. Evidence has not been presented that precludes the possibility of coincident occurrence of vascular and enzymatic changes. In fact, many of the inflammatory mediators (e.g. interleukin-1beta) found in laminitic tissues can concurrently stimulate synthesis of vasoactive substances and activate MMPs. Because enzymatic action on proteins is largely dependent on the concentrations of proteins and enzyme, the enzymatic theory is not dependent upon increased delivery of enzymes via increased capillary flow. Likewise, because vascular changes can alter tissue function via increased capillary flow and oedema formation, the vascular theory is not dependent upon decreased capillary flow. It is true that naturally acquired laminitis is widely variable in severity and predisposing diseases. Therefore, most probably there are multiple mechanisms involved in the initiation and propagation of the pathophysiologic cascade(s) and, therefore, successful intervention will necessitate multiple treatment modalities.     

Bilateral choanal atresia in a cat

A 7-month-old female spayed domestic shorthair cat was presented for investigation of stertor, open mouth breathing without apparent distress, and chronic bilateral nasal discharge that was unresponsive to antibiotics. Complete bilateral bony choanal atresia was diagnosed with computed tomography and nasopharyngoscopy. Choanal atresia is an uncommon congenital condition where the choana (nasal passage into the nasopharynx) is blocked by abnormal bone or soft tissue uni- or bilaterally. The cat's clinical signs improved dramatically immediately after trans-palatal surgical correction. Post-surgical complications included the development of nasopharyngeal scar tissue and subsequent stenosis, persistent right-sided nasal discharge, and permanent damage to the right eye (blindness and cataract formation). Nasopharyngeal stenosis was managed with repeated balloon dilatations and temporary stenting, and the owner reported an excellent quality of life at 8-month follow-up. Bilateral bony choanal atresia has not been previously reported in cats. Uni- or bilateral choanal atresia should be considered in young cats presenting with refractory stertor, chronic nasal discharge, and/or open mouth breathing.     

Effect of breed on anatomy of portosystemic shunts resulting from congenital diseases in dogs and cats: a review of 242 cases

OBJECTIVE: To evaluate the effect of species and breed on the anatomy of portosystemic vascular anomalies in dogs and cats. DESIGN: Retrospective study of 233 dogs and nine cats presenting to the University Veterinary Centre, Sydney. METHODS: Case records were evaluated for breed, sex, age, anatomical and histological diagnosis. Cases were included when a portosystemic vascular anomaly resulted from a congenital or developmental abnormality of the liver or portal venous system. RESULTS: Disease conditions included single congenital portosystemic shunt with patent portal vasculature (214 dogs, nine cats), portal vein aplasia (nine dogs), multiple acquired shunts resulting from portal vein hypoplasia (seven dogs), biliary atresia (one dog) and microvascular dysplasia (one dog). One Maltese had a single, congenital shunt and multiple acquired shunts resulting from hepatic cirrhosis. Breeds that were significantly over-represented included the Maltese, Silky Terrier, Australian Cattle Dog, Bichon Frise, Shih Tzu, Miniature Schnauzer, Border Collie, Jack Russell Terrier, Irish Wolfhound and Himalayan cat. Bichon Frise with shunts were significantly more likely to be female than male (12:2, P < 0.001). Two hundred and fourteen dogs (91.4%), and all cats, had shunts that were amenable to attenuation. Inoperable shunts occurred in 19 dogs (8.2%). Fifty six of 61 (92%) operable shunts in large breed dogs were intrahepatic, versus 10/153 (7%) in small breeds (P < 0.0001). Breeds that were not predisposed to portosystemic shunts were significantly more likely to have unusual or inoperable shunts than dogs from predisposed breeds (29% versus 7.6%, P < 0.0001). No significant relationship between breed and shunt type could be determined in cats. CONCLUSION: Breed has a significant influence on shunt anatomy in dogs. Animals presenting with signs of portosystemic shunting may suffer from a wide range of operable or inoperable conditions. Veterinarians should be aware that unusual or inoperable shunts are much more likely to occur in breeds that are not predisposed to congenital portosystemic shunts.     

Atresia ani in the dog: a retrospective study

Congenital anomalies of the rectum and anus are rare in dogs. The most frequently reported anomaly is atresia ani. Four types of atresia ani have been reported, including congenital anal stenosis (Type I); imperforate anus alone (Type II) or combined with more cranial termination of the rectum as a blind pouch (Type III); and discontinuity of the proximal rectum with normal anal and terminal rectal development (Type IV). An increased incidence was found in females and in several breeds, including miniature or toy poodles and Boston terriers. Surgical repair is the treatment of choice, but postoperative complications can occur, including fecal incontinence and colonic atony secondary to prolonged preoperative distension.     

Intestinal atresia in calves: 22 cases (1978-1988)

A retrospective study of 22 calves afflicted with intestinal atresia was performed to determine typical signs of disease, treatment, and survival rate. All 22 calves, except 2 heifers with atresia ani and rectovaginal fistula, were examined when they were between 1 and 10 days old because of depression, anorexia, abdominal distention, and lack of feces. All calves had been observed to stand and suckle shortly after birth. Survival rate was influenced by the atretic segment affected: 0% (0/2 surgically treated) for atresia jejunal; 42% (5/12 examined) or 71% (5/7 recovering from general anesthesia) for atresia coli; and 63% (5/8 examined) or 71% (5/7 surgically treated) for atresia ani. Survival appeared to depend principally on early recognition, anatomic site affected, and successful surgical establishment of a patent intestinal tract.     

Surgical Repair and Management of Congenital Intestinal Atresia in 68 Calves

Objective— To determine outcome and survival rate after surgical treatment of intestinal atresia, gender predilection, and effect of rectal palpation on the cause of atresia coli in calves.
Study Design— Prospective clinical study.
Animals— Newborn calves (n=68).
Methods— Data collected were husbandry system, anamneses, physical examination findings, surgical treatments, and postoperative results. Calves with atresia ani, and with atresia coli et recti had anal reconstruction and right flank colostomy, respectively. In midflank colostomized calves, the inner muscular layers were dissected to form a valve-like stoma.
Results— Of 68 calves with intestinal atresia, 37 were treated surgically. Anal reconstruction was performed in 21 calves with atresia ani with a long-term survival rate of at least 6 months with good condition. Colostomy was performed in 14 calves with atresia coli and 1 with atresia coli et recti; survival rate was 73%. The case morbidity rate for intestinal atresia was 13.8% and for atresia coli, 5.7% in the hospital population. No gender predilection for occurrence of atresia ani and atresia coli was identified. Palpation per rectum for early pregnancy diagnosis did not predispose to atresia coli.
Conclusion— Surgical treatment of atresia ani through circular anal skin removal has a good prognosis for survival. Colostomy is not an acceptable treatment from the calf's perspective because of the resulting poor condition but the high survival rate is important to allow continued milk production of the dam.
Clinical Relevance— Early diagnosis, supportive treatment, and surgical correction are important in management of atresia coli.     

Extrahepatic biliary atresia in a border collie

Progressive lameness and leg pain were the predominant clinical signs in a 17-week-old male border collie presented for examination. On clinical investigation, extrahepatic cholestasis in association with rickets due to inadequate vitamin D resorption was diagnosed. The dog was treated parenterally with vitamin D and a cholecystoduodenostomy was performed. At 25 days postsurgery the lameness had resolved and bone structure was radiographically normal. However, at six weeks postsurgery, the dog's condition deteriorated rapidly and euthanasia was finally performed at eight weeks postsurgery. At postmortem examination, Toxocara canis nematodes were found to have invaded the biliary system via the anastomosis between the gallbladder and duodenum, causing biliary and hepatic toxocariasis. The cause of the primary extrahepatic cholestasis was atresia of the common bile duct at the hepatic end. The liver tissue showed microscopic lesions of chronic extrahepatic cholestasis as well as acute inflammation associated with the nematode invasion. There was no postmortem evidence of bone lesions. Extrahepatic biliary atresia is extremely rare in animals and has not been described before in dogs. In contrast, it represents the most common cause of congenital cholestasis in children, occurring in approximately one per 10,000 to 15,000 live births.     

Companion animals symposium: microbes and gastrointestinal health of dogs and cats

Recent molecular studies have revealed complex bacterial, fungal, archaeal, and viral communities in the gastrointestinal tract of dogs and cats. More than 10 bacterial phyla have been identified, with Firmicutes, Bacteroidetes, Proteobacteria, Fusobacteria, and Actinobacteria constituting more than 99% of all gut microbiota. Microbes act as a defending barrier against invading pathogens, aid in digestion, provide nutritional support for enterocytes, and play a crucial role in the development of the immune system. Of significance for gastrointestinal health is their ability to ferment dietary substrates into short-chain fatty acids, predominantly to acetate, propionate, and butyrate. However, microbes can have also a detrimental effect on host health. Specific pathogens (e.g., Salmonella, Campylobacter jejuni, and enterotoxigenic Clostridium perfringens) have been implicated in acute and chronic gastrointestinal disease. Compositional changes in the small intestinal microbiota, potentially leading to changes in intestinal permeability and digestive function, have been suggested in canine small intestinal dysbiosis or antibiotic-responsive diarrhea. There is mounting evidence that microbes play an important role in the pathogenesis of canine and feline inflammatory bowel disease (IBD). Current theories for the development of IBD favor a combination of environmental factors, the intestinal microbiota, and a genetic susceptibility of the host. Recent studies have revealed a genetic susceptibility for defective bacterial clearance in Boxer dogs with granulomatous colitis. Differential expression of pathogen recognition receptors (i.e., Toll-like receptors) were identified in dogs with chronic enteropathies. Similarly to humans, a microbial dysbiosis has been identified in feline and canine IBD. Commonly observed microbial changes are increased Proteobacteria (i.e., Escherichia coli) with concurrent decreases in Firmicutes, especially a reduced diversity in Clostridium clusters XIVa and IV (i.e., Lachnospiraceae, Ruminococcaceae, Faecalibacterium spp.). This would indicate that these bacterial groups, important short-chain fatty acid producers, may play an important role in promoting intestinal health.