Abomasal fistulas in dairy cows

Abomasal fistulas were corrected surgically in 9 adult Holstein cows. Six cows had a history of right paramedian abomasopexy (RPA), and 2 cows had had a percutaneous abomasopexy using the blind-stitch technique (BSA). Fistulas developed from 2 weeks to 12 months after the RPA or BSA. In 1 cow, history was not available beyond 2 years, and no surgery had been performed in that time. All fistulas were in the right paramedian area and were draining blood and/or ingesta from necrotic abomasal tissue (8 cows) or ruminal tissue (1 cow). Surgery was performed immediately in cows with consistent hemorrhage from the fistulated tissue (4 cows). Surgery was delayed to reduce rumen contents if bleeding was absent or considered negligible (4 cows) or to stabilize the patient (1 cow). General anesthesia was used in 7 cows, local anesthesia in 2 cows. Outcome following the fistula resection was successful in the 7 cows discharged from the clinic. The occurrence of abomasal fistulation is probably related to nonabsorbable sutures penetrating the abomasal lumen during the abomasopexy procedure resulting in infection of the incision or body wall.