ABSTRACT
ABSTRACT: The use of two cerclages with wire spirals as distractor spacers was evaluated for the correction of pelvic stenosis in felines. A three-year-old, mixed-breed, male feline was taken to the Veterinary Hospital of the UFRJ. It presented symptoms of constipation, dyschezia, hyporexia and mild apathy. On radiographic examination, a deformation of the pelvic bones and a narrowing of the pelvic canal were detected. The patient underwent pelvic stenosis correction surgery. Two spirals were made with cerclage wire and 2.0-mm diameter Steinmann pins; coupled to the chuck of a drill, the pins were wrapped with cerclage wire, running laps around the pin. Then, the coils were positioned in the space formed by separating the hemipelves and stabilized by keeping them separated to the desired opening. Effectiveness of the technique was evidenced by measurements made using new radiographic images in comparison with the images obtained before the surgical procedure. There were evident decreases in the sacro-ischium line and pubic line of 3.98 and 3.18, demonstrating an increase of approximately 21% in the pelvic canal diameter. The animal showed no apparent macroscopic or radiographic reaction. The preliminary clinical application of the adapted pelvic distraction technique is relevant for allowing the appropriate correction of a stenosis of the pelvic girdle and its consequences, representing a major technical and scientific innovation in the correction.
RESUMO: Avaliou-se o uso de duas espirais confeccionadas com fio de cerclagem como preenchimento distrator para correção de estenose pélvica em felinos. Foi atendida no Hospital Veterinário da UFRJ um felino macho, sem raça definida com idade de 3 anos, apresentando sintomas de constipação, disquezia, hiporexia e apatia leve. Ao exame radiográfico, observou-se deformação de ossos da pelve com estreitamento do canal pélvico. O animal foi operado para correção da estenose pélvica. Foram confeccionados dois espirais com fio de cerclagem e um pino de Steinmann de 2,0mm de diâmetro acoplado ao mandril de uma perfuratriz, envolveu-se este pino com o fio de cerclagem, executando voltas ao redor do pino. Em seguida, os espirais foram posicionados no espaço formado pela separação das hemipelves, e estabilizados, mantendo-as separadas com a abertura desejada. A efetividade da técnica foi evidenciada por medições feitas através de novas imagens radiográficas, permitindo assim uma comparação com a imagem obtida anteriormente ao procedimento cirúrgico. A aplicação clínica da técnica é relevante por permitir que a correção apropriada da estenose da cintura pélvica e suas consequências representa uma importante inovação técnica e científica na correção dessa condição.
ABSTRACT
Horse-shoe kidney is a congenital anomaly which is associated with calculous formation and pelviureteric junction obstruction due to the abnormal lie of the pelvis and ureters. The patient presents as pain in abdomen, recurrent urinary tract infection, lump in abdomen, haematuria and pyuria. Division of the isthmus and simultaneous nephropexy corrects the lie of the pelvis and ureters and is recommended as the surgery for symptomatic horse-shoe kidney. If the pelviureteric junction is dependent and funnel shaped, simple nephropexy in lower polar diversion position will suffice but if there is high insertion of the ureter, some form of pyeloplasty is mandatory. A contralateral nephropexy, at a later stage, is also recommended.