Uterine torsion in a Sprague Dawley rat (Rattus norvegicus)

Uterine torsion is a twisting of the uterus or uterine horn perpendicular to its long axis. We report a case of uterine torsion in an adult breeding Sprague Dawley rat. The rat died a month after her last recorded delivery. Post mortem examination of the rat revealed 270 degrees torsion of the right uterine horn. The uterus contained a single foetus. The liver was pale and enlarged. The rest of the viscera appeared normal. Histopathological examination showed acute hepatic necrosis and pulmonary congestion with mild lymphocytic infiltrates peribronchially. The acute hepatic necrosis may have been associated with septicaemia due to compromised blood vessels following the uterine torsion. The presence of a single foetus could have resulted in foeto-maternal disproportion with resultant uterine torsion. Torsion of the uterus can be accompanied by haemostatic and metabolic complications, which could have caused the death of the rat. Although uterine torsion is a rare condition in rats, it should be considered as a potential complication of gestation in animal breeding units.     

Uterine torsion in cattle - frequency, clinical symptoms and theories about the pathogenesis

Aim of the present study was to summarize the available literature about the incidence, frequency, clinical symptoms and ideas as to the pathogenesis of uterine torsion in the cow. MATERIALS AND METHODS: Analysis of the literature using electronic libraries (Pub Med, Medline), German veterinary medicine journals and obstetrical textbooks. RESULTS: Uterine torsion is a very important maternal reason for dystocia as most cases occur during parturition. The post-cervical torsion (combined uterine and vaginal torsion, Torsio uteri and vaginae) is more commonly diagnosed than an intra-cervical or pre-cervical torsion. Torsions to the left occur more frequently than to the right. Clinical symptoms clearly vary depending on the degree of torsion. The frequency in relation to all parturitions is described as between 0.5 and 1%, whereas the percentage of uterine torsions presented to the veterinarian as a reason for dystocia varies between 2.7 and 65%. The pathogenesis of uterine torsion remains unclear; however, general agreement exists that the cow is predisposed to uterine torsion due to its anatomy. It appears that the Brown Swiss is more often affected than other cattle breeds.     

Splenic torsion in an alpaca

OBJECTIVE: To describe the clinical signs, diagnostic evaluation and surgical management of an alpaca with splenic torsion. ANIMALS: Six-year-old female alpaca. RESULTS: Splenic torsion and uterine torsion were the inciting cause for persistent abdominal discomfort in this alpaca. Rectal examination, abdominocentesis, and transabdominal ultrasonographic findings were suggestive of a splenic lesion. Surgical management involved splenectomy of a necrotized spleen. CONCLUSIONS: Although rare in occurrence, splenic torsion should be considered as a potential cause of abdominal discomfort in alpacas. Splenectomy is a reasonable and successful method of treatment for a devitalized spleen secondary to splenic torsion in alpacas. CLINICAL RELEVANCE: Splenic torsion causes persistent abdominal discomfort in camelids and may be associated with uterine torsion. Rectal examination, transabdominal ultrasound and abdominocentesis are useful diagnostic tools to differentiate splenic torsion from other causes of abdominal discomfort. Splenectomy is an uncomplicated procedure in camelids and has a favorable prognosis.     

THE HILAR PERIVENOUS HYPERECHOIC TRIANGLE AS A SIGN OF ACUTE SPLENIC TORSION IN DOGS

Diagnosis of acute primary splenic torsion is challenging. The ultrasonographic appearance of this condition has been described, but other splenic diseases, such as diffuse infarction because of thrombosis, can appear very similar. We describe an additional ultrasonographic sign of acute splenic torsion; a triangular hyperechoic area at the hilus between the veins and the splenic parenchyma that is continuous with the hyperechoic mesentery. In a group of animals where acute splenic torsion was part of the ultrasound report differential diagnosis, we compared findings in dogs with torsion with findings in dogs with other splenic conditions. The presence of a hilar hyperechoic perivenous triangle was significantly associated with splenic torsion (P = 0.005). We speculate that this sign is associated with torsion because of the secondary severe, diffuse splenic enlargement. Although not pathognomonic, this sign could be used to more accurately diagnose splenic torsion in light of other findings consistent with this condition.     

Accuracy of increased large-intestine wall thickness during ultrasonography for diagnosing large-colon torsion in 42 horses

Large-colon torsion is a common cause of colic in horses and has a worse prognosis and higher cost than other causes of surgical colic of the large colon. During large-colon torsion, the colon wall becomes thick due to vascular occlusion. Therefore, we hypothesized that detecting increased colon wall thickness during ultrasonography would be an accurate preoperative test for large-colon torsion. The sample population consisted of 42 horses that were admitted for surgical treatment of colic localized to the large colon. The diagnosis was confirmed at surgery or necropsy examination. Twelve (29%) of these horses were diagnosed with large-colon torsion. Duplicate ultrasonographic measurements of colon wall thickness were made at six abdominal locations and an average measurement was calculated. For four of these six sites, a significant difference (P < 0.005) was detected between horses with and without large-colon torsion. All four tests were moderately sensitive and highly specific for diagnosing large-colon torsion using five decision criteria. Using a ventral abdominal window, a colon wall thickness > or = 9 mm accurately predicted large-colon torsion in eight of the 12 horses (sensitivity, 67%; confidence interval [CI], 36-98%) and correctly predicted that large-colon torsion was absent in 28/28 horses (specificity 100%; CI, 98-100%). Intraobserver repeatability was assessed by evaluating the difference between the first and second measurements obtained, which was < or = 2 mm. Therefore, detecting increased large-colon wall thickness during ultrasonography is a reproducible and accurate preoperative test for large-colon torsion in horses with surgical colic localized to the large colon.     

Successive torsion of the right middle and left cranial lung lobes in a dog

This case report describes the torsion of two lung lobes in a dog. The animal was first presented for a torsion of the right middle lung lobe. Following the surgical resection of that lobe, the dog suffered another torsion of the left cranial lung lobe (cranial and caudal segments).     

The effect of uterine torsion on mare and foal survival: a retrospective study, 1985--2005

REASONS FOR PERFORMING STUDY: Anecdotal speculation suggests that prognosis for survival of mares and foals following correction of uterine torsion has improved over the past 30 years. OBJECTIVES: To determine statistically the outcome of uterine torsion according to duration of clinical signs, stage of gestation, parity, physical examination findings, method of correction, prognosis for survival and reproductive health of the mare, and prospects for the foal within the neonatal period. METHODS: This retrospective study combined cases from 4 equine referral hospitals. RESULTS: The stage of gestation at which uterine torsion occurred was a risk factor for survival of mare and foal. Overall mare survival was 53/63 (84%); when uterine torsion occurred at < 320 days gestation, 36/37 (97%) of mares survived compared to 17/26 (65%) survival rate when uterine torsion occurred at > or = 320 days gestation. Overall foal survival was 54% (29/54). When uterine torsion occurred at < 320 days gestation, 21/29 (72%) foals survived compared to 8/25 (32%) when uterine torsion occurred at > or = 320 days gestation. Thirty mares were discharged from the hospital carrying a viable fetus following uterine torsion correction and 25/30 (83%) of these mares delivered live foals that survived beyond the neonatal period. CONCLUSIONS: Prognosis for survival for mares and foals following uterine torsion is good and improves if torsion occurs < 320 days compared to > or = 320 days gestation. CLINICAL RELEVANCE: Gestational timing of uterine torsion should be considered when advising clients about the prognosis for survival of the mare and foal. The prognosis for a mare delivering a live foal is good if the mare is discharged from the hospital following uterine torsion correction with a viable fetus.     

Torsion of the uterus--a cause of colic in the mare.

A case of uterine torsion in a mare with colic is described in which an early diagnosis was made and the torsion successfully reduced through a standing laparotomy with survival of both the mare and the foal. This case is used to stress the importance of thorough examination of all pregnant mares with colic in order to differentiate uterine torsion from other causes of abdominal pain, thereby avoiding delay in surgical correction and reducing the risk of fetal and/or maternal death. The advantages of the standing laparotomy are presented in support of this method of treatment of torsion of the gravid uterus.     

Torsion of the Uterus — A Cause of Colic in the Mare

A case of uterine torsion in a mare with colic is described in which an early diagnosis was made and the torsion successfully reduced through a standing laparotomy with survival of both the mare and the foal. This case is used to stress the importance of thorough examination of all pregnant mares with colic in order to differentiate uterine torsion from other causes of abdominal pain, thereby avoiding delay in surgical correction and reducing the risk of fetal and/or maternal death. The advantages of the standing laparotomy are presented in support of this method of treatment of torsion of the gravid uterus.     

Validation of a Technique to Assess Radial Torsion in the Presence of Procurvatum and Valgus Deformity Using Computed Tomography: A Cadaveric Study

Objective— To validate a technique to assess radial torsion with and without procurvatum and valgus deformity using computed tomography (CT).
Study Design— Anatomic study.
Animals— Radii (n=3) from normal dogs.
Methods— Three cadaveric radii were scanned using CT (3 mm slices). Transverse image sections were assessed at the distal and proximal physeal scar parallel to the joint surface in both sagittal and dorsal planes. Anatomic landmarks of the radius were identified and torsion was measured. A hinged Ilizarov circular external skeletal fixator was constructed to create known procurvatum, valgus, and torsional deformities.
Results— Between observers results were highly correlated for calculation of torsion (r=0.972, r²=0.9448, P <.00001). Mean baseline torsion of the radius in the construct was 4.88°. At 20° procurvatum and valgus, mean calculated torsion was 5.07° (confidence interval [CI]=4.6–5.6°). At 20° procurvatum and valgus with 22.5°-induced torsion, mean measured torsion was 25.4° (expected=27.38°; CI=22.7–28.1°). At 40° procurvatum and valgus and 45°-induced torsion, mean measured torsion was 51.1° (expected=49.88°; CI=−49.2 to 53.0°).
Conclusion— Assessment of radial torsion by CT is reproducible and accurate in the presence of procurvatum and valgus antebrachial angular limb deformities in the dog.
Clinical Relevance— Despite complex presurgical planning, current measurements only allow for measurement of valgus and procurvatum deformities in the sagittal and dorsal planes, this method allows for more precise measurements of radial torsion in the transverse plane.     

Segmental lung lobe torsion in a 7-week-old Pug

Case summary: A 7‐week‐old, intact female Pug was referred with an acute history of expiratory dyspnea, tachypnea, and pyrexia. Radiologic evaluation revealed bilateral pleural effusion and a poorly demarcated area of soft tissue opacity cranial to the heart. The presence of air bronchograms in the cranial lung lobes suggested alveolar parenchymal pathology consistent with pulmonary edema, congestion, or cellular infiltration. Exploratory thoracotomy revealed a segmental torsion of the left cranial lung lobe. The affected lobe was removed and the puppy recovered uneventfully. Unique information: Lung lobe torsion tends to occur more frequently in mature large breed dogs at a mean age of 3 years. The age, breed, and segmental nature of the torsion in the reported case are contrary to most of the previously documented cases of lung lobe torsion. To the authors' knowledge, this is the first report of lung lobe torsion in a 7‐week‐old dog.     

RADIOGRAPHIC AND COMPUTED TOMOGRAPHIC DETERMINATION OF FEMORAL VARUS AND TORSION IN THE DOG

Diagnosis and quantification of femoral varus and femoral torsion using radiographs is technically challenging due to the difficulty in determining proper positioning. The purpose of this study is to describe a computed tomographic technique for determination of femoral varus and femoral torsion and to compare this technique, and standard radiography, to anatomic preparation, for the measurement of femoral varus and femoral torsion in normal dogs. Nine canine cadavers, visually and radiographically free of orthopedic disease of the hip and stifle joints, were utilized for analysis. Femoral varus was determined using a craniocaudal radiograph, a craniocaudal radiograph obtained after confirming accurate positioning using horizontal beam fluoroscopy, and computed tomography (CT). Femoral torsion (expressed as angle of version) was determined using an axial radiographic projection obtained from distal to proximal and CT. Each femur was dissected free of soft tissues, and direct determination of femoral varus and femoral torsion was performed using digital photographic images. All radiologic and photographic images were digitally measured to quantify the magnitude of femoral varus and femoral torsion. For femoral varus, no difference ( P =0.149) between the three different imaging techniques and the anatomic preparation was identified. For femoral torsion, no difference ( P =0.059) between the two imaging techniques and the anatomic preparation was identified. Well positioned radiographs and the described computed tomographic method are both as accurate as anatomic preparation for the measurement of both femoral varus and femoral torsion in normal dogs.     

Tussive syncope in a pug with lung-lobe torsion

The most common presenting clinical signs of lung-lobe torsion include dyspnea, tachypnea, lethargy, and anorexia. Tussive syncope secondary to lung-lobe torsion has not been documented. This article describes the presentation, diagnosis, management, and outcome of a pug with tussive syncope secondary to lung-lobe torsion.     

Testicular torsions in veterinary medicine

The purpose of this review is to provide a comprehensive comparison of spermatic cord torsion in domestic animals. Spermatic cord torsion leads to occlusion of testicular blood flow resulting in ischemia and tissue hypoxia. Spermatic cord torsion has been reported in all domestic mammals but dogs and horses are overrepresented. Abdominal pain (colic), anorexia, vomiting, lameness, and stiff gait are the most common clinical signs reported. The condition may be asymptomatic in cases of a low degree of spermatic cord torsion. In dogs, spermatic cord torsion is most commonly reported in undescended testes, which in some cases are neoplastic. However, in horses, spermatic cord torsion occurs more commonly in scrotal testes. Surgical treatment for spermatic cord torsion depends upon the degree and duration of torsion. If the affected testis is located within the scrotum and determined to still be viable, detorsion with orchidopexy can be performed. Orchiopexy of the unaffected scrotal testis is also recommended in stallions. If the affected testis cannot be salvaged, unilateral or bilateral orchidectomy is recommended. In all cases of spermatic cord torsion of an undescended testis, orchidectomy is recommended. Veterinarians should be aware of the clinical signs and treatment options for spermatic cord torsion in domestic mammals.

Graphical abstract

     

CT findings in five dogs with surgically confirmed colonic torsion

Colonic torsion is a life‐threatening condition that results in colonic ischemia, necrosis, perforation, sepsis, and eventual death. The aim of this multicenter, retrospective case series study was to describe the CT findings in dogs with surgically confirmed colonic torsion. Medical records were searched for dogs with surgically confirmed colonic torsion following abdominal CT. Five dogs met the inclusion criteria. Three had a history of chronic intermittent diarrhea prior to presentation. Two dogs presented with acute vomiting, diarrhea, and abdominal pain and one dog presented with acute vomiting and lethargy. Computed tomographic findings in all dogs with surgically confirmed colonic torsion include: “whirl sign,” displacement and distension of the cecum and colon, focal narrowing of the colon, and distension of the mesenteric vasculature in all dogs (5/5); streaky peritoneal fat and peritoneal effusion (4/5), pneumatosis coli (2/5), small intestinal distension (2/5), portal vein thrombosis (1/5), and reduced colonic wall contrast enhancement (1/5). In all dogs (5/5), the torsion site was the descending colon and demonstrated an anticlockwise rotation. At surgery, three of the five dogs had a partial colonic torsion with hyperemia at the site of obstruction and two of the five dogs had a complete torsion with marked necrosis of the colonic wall. Displacement of the colon and cecum, segmental distension and focal narrowing of the colon, the presence of a “whirl sign” and distension of the mesenteric vasculature are CT findings highly suggestive of colonic torsion.     

Computed tomographic features of urinary bladder torsion in two dogs

Urinary bladder torsion is rare in dogs. It is characterised by rotation of the organ along its longitudinal axis and is potentially life‐threatening because of urinary flow obstruction with subsequent urine retention, hydroureter, hydronephrosis and azotaemia. This report describes the computed tomographic features of urinary bladder torsion in two dogs. In both cases, the hallmark indicative of torsion was the “whirl sign,” originating from the twisted pelvic urethra and urinary bladder neck encircling the ureters, blood vessels and bladder ligaments in a characteristic spiral pattern. The imaging features correlated well with surgical findings, demonstrating high sensitivity of computed tomography in the preoperative diagnosis of urinary bladder torsion.     

Resolution of severe thrombocytopenia in two standard Poodles with surgical correction of splenic torsion

Objective: To describe the diagnosis and treatment of 2 cases of severe thrombocytopenia associated with splenic torsion and to discuss the pathophysiologic mechanisms underlying the thrombocytopenia. Summary: We report 2 cases of severe thrombocytopenia associated with splenic torsion. Each dog presented with non‐specific clinical signs, radiographic evidence of an intra‐abdominal mass, and platelet counts of less than 25,000 platelets/μL. The diagnosis of splenic torsion was made with abdominal ultrasonography and was confirmed during exploratory laparotomy. Both dogs recovered rapidly following splenectomy. The cause of thrombocytopenia associated with splenic torsion is not fully elucidated, but may be because of either platelet sequestration within the torsed spleen, platelet consumption in disseminated intravascular coagulation, or a combination of both. New information provided: This report provides previously unreported evidence that the degree of thrombocytopenia associated with splenic torsion may be of a severity at which primary hemostasis is compromised, and resolution of thrombocytopenia occurs after splenectomy.     

优化腹壁施压配合母体翻转治疗牛子宫扭转的分析思考

子宫扭转作为母牛临床上的一种产科疾病,如遇处置不当极易造成母牛和胎儿死亡,引起严重的经济损失。在借鉴郭俊清研究成果的基础上,通过优化腹壁施压配合母体翻转进行牛子宫扭转的处置,取得了良好的效果。为此本文在分析牛子宫扭转发病原因的基础上,就优化腹壁施压配合母体翻转进行牛子宫扭转的处置进行讨论,提出了相应的操作要点,为提高牛子宫扭转的临床处置成功率提供一定的技术参考。     

Influence of uterine torsion in water buffaloes (Bubalus bubalis) with insights into the hematological and biochemical prognostic values regarding to manual correction

Bovine uterine torsion refers to the rotation of the gravid uterus around its longitudinal axis. It is the dominant cause of dystocia in buffaloes. A total of two hundred and seventeen dystocia’s Egyptian buffaloes were examined, and another twenty were apparently normal at the full term (healthy pregnant group). From the dystocia’s buffaloes, twenty-three percentage (n = 50) was uterine torsion after gynecology inspection at presentation (Ut group) and 5 days after the manual correction (Utc group). The buffaloes with uterine torsion exhibited loss of appetite, constipation, colic, and straining. The incidence of torsion was mostly at first parity that accounting for 50% of cases. Regarding to the pregnancy stage, torsion mostly occurred at full term, where it primarily occurred in buffaloes at 3 years of age. Right-sided torsion ensued in 90% of all cases. The survival rate of the pregnant buffaloes was 90% (45 buffaloes), and 10% (5 buffaloes) was directed to the culling. Regarding to the fetal survival outcome, 30% of fetuses was survived where the other 70% was died. The hematological results denoted leucocytosis in Ut and Utc groups that attributed to neutrophilia, monocytosis, and eosinophilia. Biochemical assessments were denoted an augments in the levels of serum AST, LDH, CPK, creatinine, blood urea nitrogen, progesterone, cortisol, MDA, NO, TAC, blood lactate (bLac), TNF-α, and IL-6. Where there were a non significant fluctuations in the ALT, GGT, calcium, and phosphorus levels in the torsion cases. The significant declines in 17-β-oestradiol, total proteins, albumin, magnesium, and GSH levels in the dams suffering from Ut were observed. The robust elevations in AST (156 ± 3.47) and bLac (16.12 ± 0.18) with severe hypomagnesaemia (2.69 ± 0.15) were evident in 10% of the torsion cases that directed to the culling. This can conclude that robust elevations in AST and bLac with severe hypomagnesaemia are factors denoting a poor prognosis for uterine torsion in the buffaloes.

     

Bilateral segmental aplasia with unilateral uterine horn torsion in a pomeranian bitch

Bilateral segmental aplasia of the uterine horns with unilateral pyometra and uterine horn torsion were diagnosed in a Pomeranian bitch that presented with chronic abdominal distension and an acute onset of anorexia and lethargy. Because radiographic and ultrasonographic findings revealed the presence of markedly enlarged bilateral uterine horns filled with fluid in the caudal abdomen, a tentative diagnosis of either pyometra or hydrometra with uterine horn torsion was made. Exploratory laparotomy showed bilateral, segmentally distended uterine horns with unilateral uterine horn torsion. Ovariohysterectomy was performed, and bilateral segmental aplasia of the uterine horns with the development of unilateral uterine horn torsion was diagnosed histopathologically. To the authors' knowledge, this is the first report of uterine horn torsion in conjunction with segmental aplasia of the uterine horn in a bitch.