开腹术治疗犬嵌闭性阴囊疝一例

笔者于2004年6月8日。对凯里市金井村养犬专业户鲁某的一只息嵌闭性阴囊疝的病犬。采用开腹术救治。疗效满意。现报道如下。     

Laparoscopic Abdominal Anatomy of Foals Positioned in Dorsal Recumbency

Eleven foals (nine cadavers and two anesthetized) positioned in dorsal recumbency were examined to describe normal abdominal anatomy viewed by laparoscopy. The foals ages ranged from 1 to 150 days. Insertion sites were selected for a Verres needle, laparoscope and instrument portals to avoid trauma to the umbilical structures. The abdominal cavity was insufflated to a pressure of 10 to 12 mm Hg using an automatic carbon dioxide insufflator. Laparoscopic examination allowed excellent observation of the umbilical structures, the bladder, the genital tract, the inguinal area, the liver and segments of the intestinal tract in all foals. However, the duodenum and ileum were not identified. An embryonic vestige of the yolk stalk (ductus pedunculi vitellini) was identified in six foals. In four foals, this appeared as a fibrous band extending from the umbilicus to the cranial abdominal cavity where it inserted on the small intestine. In two foals only the fibrous umbilical portion of the band was observed.     

创伤性膈疝修复术

本病例通过对创伤性膈疝实施手术修复,并对膈疝成因及手术成功的因素做了总结,对于该类手术的实施及预后,有了进一步的经验积累。     

Surgical Correction of Bilateral Ectopic Ureters in Two Foals

Case reports of ectopic ureters in a 2 1/2-month-old colt and a 4 1/2-month-old filly are presented. Diagnosis was made by retrograde cystography and excretory urography. The ureters were surgically transposed into the bladder. A functional urinary system was reestablished in both foals, but they died of postoperative complications.     

Diaphragmatic Hernia Repair in Three Young Horses

Objective- This clinical report describes surgical correction of diaphragmatic hernia in three young horses.
Study Design- Retrospective investigation of medical records and subsequent racing performance.
Animals- Three young horses with diaphragmatic hernia.
Results- Three young horses with signs of abdominal pain had diaphragmatic hernia causing small intestinal strangulation. The strangulated small intestine was resected and an end-to-end jejuno-jejunal (two horses) or a side-to-side jejuno-cecal anastomosis (one horse) was performed. Diaphragmatic hernias were closed with a continuous suture pattern. All horses recovered and raced. No difference in race records was found between the subject horses and their siblings. One subject horse died of colic at 5 years of age, but the cause of the colic was undetermined. The remaining two horses are in use as broodmares and have produced multiple foals without recurrence of signs of diaphragmatic hernia
Conclusions- Diaphragmatic hernias can be repaired in horses. These horses can achieve race records similar to their siblings and can produce foals without recurrence of signs of diaphragmatic hernia.     

Bacterial Endocarditis in Two Spanish Foals After Neonatal Septicemia

Equine neonatal septicemia could lead to the release of thrombus and heart valvular endocarditis. A relationship between activation of the renin-angiotensin-aldosterone-vasopressin (RAAV) axis and heart failure has been described in several species. This article describes the echocardiographic, electrocardiographic, and laboratory findings, including RAAV axis, in two Spanish foals with endocarditis after septicemia in comparison with two control groups matched by age and gender. Two Spanish foals (F1, 60-day-old colt; F2, 76-day-old filly) were presented with poor growth rate a month after being hospitalized because of septicemia. Colt F1 had hypercortisolemia and increased left ventricular internal dimensions in systole and diastole, increased left ventricular free wall thickness in diastole, interventricular septum thickness in diastole, and mitral valve thickness. Colt F1 also presented lower fractional shortening, ejection fraction, fractional wall thickness, and fractional septum thickness. Filly F2 showed hyperfibrinogenemia and increased values for aspartate aminotransferase, lactate dehydrogenase, creatin kinase, alkaline phosphatase, interventricular septum at systole, aorta diameter at the level of valve leaflets and sinotubular junction, and mitral and tricuspid valve thickness. The foals did not present systemic signs compatible with heart failure, heart arrhythmias were not found, and RAAV values were within the expected confidence limits. In conclusion, endocarditis without clinical signs of heart failure can appear shortly after septicemia in equine neonates. The measurement of the thickness of the valves by two-dimensional echocardiography is diagnostic. The lack of activation of RAAV in both foals might indicate that the severity of the heart problem was mild.     

Contracted Foal Syndrome Associated with Multiple Malformations in Two Foals

Congenital anomalies in horses are very rare, and contracted foal syndrome is one of the most commonly reported. This malformation is characterized by contraction of the joints of the forelimbs and/or hindlimbs. In addition, the syndrome can be characterized by vertebral column malformations, such as scoliosis or torticollis, and cranial deformity. The present report describes the radiological and necroscopical findings of multiple rare malformations in two foals. Both foals showed skeletal abnormalities and fenestration of the abdominal cavity. Other pathological findings include a interventricular septal defect in one and a unilateral hydronephrosis and partial hydroureter in the other foal. Although in this report a specific aetiology could not be provided, insecticides treatment provided during the second month of pregnancy might play a role in the pathogenesis of these malformations.     

犬双侧复杂会阴疝的一次性修复

会阴疝是老年犬临床常见病,手术是唯一的修复办法。目前常用的修复手术采用俯卧保定,手术难度大,一般一次只能修复一侧疝孔,术后容易复发。作者介绍了一种创新的术式：通过修复前进行结肠、膀胱腹腔固定术,极大地减小了复杂会阴疝修复手术的难度和术后复发的可能性;通过两后肢向前保定的仰卧保定术式,可以一次性修复双侧会阴疝。     

The Diagnosis and Surgical Correction of Congenital Portosystemic Vascular Anomalies in Two Calves and Two Foals

Two calves and two foals presented with episodic clinical signs of diffuse central nervous system disease. Portosystemic anomalies were tentatively diagnosed based on the history, clinical signs, and increased serum concentrations of blood ammonia and total serum bile acids with normal concentrations of liver derived enzymes. One calf died before intraoperative contrast portography, whereas the other calf and both foals had marked clinical improvement after intensive medical therapy. Surgical correction was attempted in these three animals and was successful in one foal. A right paracostal celiotomy was superior to a ventral median approach for exposure to the portal vascular system and shunt access.     

Acellular Dermal Matrix for Surgical Repair of Ventral Hernia in Horses

The aim of the present study was to evaluate acellular dermal matrix (ADM) of rat origin for the repair of ventral hernia in horses. The skin from rats, to be used as a graft, was de-epithelialized using hypertonic solution and further decellularized with 0.5% sodium dodecyl sulfate and 0.25% tri-(n-butyl)-phosphate. Under general anesthesia, the hernial ring was exposed and repaired with the ADM graft using inlay graft technique. Blood samples were collected at postimplantation days 0, 15, and 30 and were used for sodium dodecyl sulfate polyacrylamide gel electrophoresis analysis to assess the serum protein concentration of the animals, as well as for gelatin zymography for the identification of matrix metalloproteinases. All animals had an uneventful recovery without clinical signs of wound dehiscence, infection, or recurrence of hernias during 6-month follow-up period. Sodium dodecyl sulfate polyacrylamide gel electrophoresis analysis of concentration of the serum proteins revealed that this was increased at day 15 and had decreased again at day 30. Gelatin zymography showed only one major band of 92 kDa in the serum of all the horses with the implant, but the relative amount of 92 kDa was higher at day 15 as compared with day 0 and day 30. It may be concluded that ADM of rat origin can be used safely in horses for repair of ventral hernia.     

Evaluation of 2 Types of External Skeletal Fixation for Repair of Experimental Tibial Fractures in Foals

Transverse or oblique midshaft tibial osteotomies were created in 11 foals. The osteotomies were repaired during the same procedure using external skeletal fixation in either full splint or 3-dimensional (3-D) tent configurations. Four of the six foals receiving the full splint fixator recovered to full soundness; two were euthanized because of complications. The foals receiving the 3-D tent configuration would not bear weight on the limbs and consequently suffered significant secondary fracture disease. These foals were euthanized for humane reasons before the scheduled termination of the project. The full splint configuration is considered a viable option for use in foals less than 150 kg with fractures that are not amenable to other proven method of repair.     

Laparoscopic Repair of a Bladder Rupture in a Foal

Ruptured bladder was diagnosed in a 90-day-old Thoroughbred colt that had suffered a open, comminuted tibial fracture 2 days earlier. The bladder rupture was identified by laparoscopic examination of the abdomen and was repaired using a laparoscopic stapling instrument. This technique provided good visualization and allowed repair of the rupture with minimal intervention. Ten months after surgery, the foal was admitted to a referral surgical practice because of colic and stanguria. A urinary calculus was removed from the penile urethra by urethrotomy. Laparoscopic repair of the bladder with nonabsorbable staples may be contraindicated because of possible urolith formation.     

Idiopathic Hypocalcemia in Foals

Five thoroughbred foals (4 fillies and 1 colt), all in good to excellent body condition, ranging in age from 4 days to 5 weeks at the time of onset of signs, were presented to 2 Kentucky equine hospitals from 1992 through 1996. All 5 foals presented with tachycardia, hyperhidrosis, diarrhea or a recent history of diarrhea, and muscle rigidity or stiff gait. Four of the 5 foals presented for recumbency, seizure-like activity with opisthotonos, or pronounced extensor muscle rigidity. All 5 foals were hypocalcemic. All foals either died or had euthanasia performed. None responded to oral calcium supplementation. The cause of the hypocalcemia was unknown. Different idiopathic hypocalcemia syndromes may exist in foals.     

Hepaticojejunostomy for Treatment of Common Hepatic Duct Obstructions Associated with Duodenal Stenosis in Two Foals

Two female Standardbred foals 2 and 3 months of age were presented with signs of gastroduodenal obstruction that was confirmed with contrast radiography and exploratory surgery. Ventral midline celiotomy was performed, showing stenosis of the duodenum proximal and distal to the hepatopancreatic ampulla. The common hepatic duct, the pancreatic duct, and the sigmoid section of the duodenum proximal to the stenosis were greatly dilated. To bypass the intestinal obstruction, a side-to-side duodenojejunostomy was performed. Obstruction of the common hepatic duct was relieved by side-to-side hepaticojejunostomy. In addition, jejunojejunostomy was performed distal to the other anastomoses. Both foals recovered. On admission, the foals' total bilirubin, aspartate aminotransferase, and gamma glutamyl transferase levels were greatly elevated. During the subsequent 6 to 8 months, they returned to normal. Six months after the first surgery, one foal was readmitted with an acute abdominal crisis. At surgery, there was greater than 360 degrees clockwise rotation of the mesenteric root involving most of the jejunum. At necropsy, the previously created stomas were patent. The liver and bile duct were grossly and histologically normal. The second foal continues to progress normally 12 months after surgery.