Ultrasonographic findings in cows with dilatation, torsion and retroflexion of the caecum

Thirty cows with caecal dilatation underwent clinical and ultrasonographic examinations, followed by a right flank laparotomy and surgical correction. The intraoperative findings were compared with the results of the ultrasonographic examination. The appearance, position, dimensions, diameter and nature of the contents of the caecum and proximal and spiral ansa of the colon were determined with a 3.5 MHz linear transducer. The wall of the proximal ansa of the colon and of the dilated caecum closest to the abdominal wall was visible in all the cows and appeared as an echogenic semicircular line immediately adjacent to the peritoneum. The contents of the caecum and of the proximal and spiral ansa of the colon were not visible in 21, 25 and 25 cows, respectively, owing to gas. In the remaining cows, the contents were hypoechogenic to echogenic in appearance. In all of the cows, the dilated caecum was imaged from the right abdominal wall at the level of the tuber coxae. The caecum was imaged from the 12th, 11th and 10th intercostal spaces in 11, five and three cows, respectively. The caecum and proximal ansa of the colon were situated immediately adjacent to the right abdominal wall in 28 cows, but in the other two cows parts of these structures were pushed away from the abdominal wall by the liver or gall bladder. The diameter of the caecum, measured at various sites varied from 7.0 to 25.0 cm. Caecal dilatation was diagnosed on the basis of the results of rectal examinations in 28 of the cows, but in all 30 cows on the basis of the results of the ultrasonographic examinations. Dilatation and caudal displacement of the caecum were diagnosed in 18 cows; dilatation and cranioventral retroflexion of the caecum were diagnosed in six cows, and dilatation and craniodorsal retroflexion of the caecum were diagnosed in two cows. In the four other cows, the direction of the retroflexed caecum could not be determined. The diagnosis of caecal dilatation based on the ultrasonographic findings was confirmed in all the cows during exploratory laparotomy. The results of ultrasonography and exploratory surgery with regard to the position of the dilated and sometimes retroflexed or twisted caecum were in complete agreement in 18 cases, in partial agreement in eight cases, but in four cases did not agree.