RESUMO
This report describes a horse presenting ileal impaction that went through a right flank laparotomy procedure while standing. The decision to use this technique was made under the influence of several factors: the patient exhibited a calm temperament and demonstrated responsiveness to the analgesic treatment for pain control; the abdominal lesion was amenable to correction by a standing right flank approach. Also, the owner reported financial problems. Ileal obstruction was relieved successfully, and the horse recovery was satisfactory. This case highlights that, in specific cases of colic syndrome, the use of surgical procedures in the standing position might be a viable option and promote fast recovery.(AU)
Este relato de caso descreve um equino com compactação de íleo corrigida por laparotomia em estação pelo flanco direito. A decisão dessa abordagem foi influenciada por vários fatores: o paciente exibiu um temperamento calmo e demonstrou responsividade ao tratamento analgésico para controle da dor; a afecção intestinal em questão foi passível de correção pela abordagem pelo flanco direito em estação; e o proprietário relatou limitações financeiras. A desobstrução ileal foi realizada com sucesso e o cavalo apresentou recuperação satisfatória. Este caso destaca que, em casos específicos da síndrome de cólica, o uso de um procedimento em estação pode ser uma abordagem viável e promover uma rápida recuperação.(AU)
Assuntos
Animais , Cavalos/cirurgia , Doenças do Íleo/veterinária , Íleo/cirurgia , Obstrução Intestinal/urina , Laparotomia/veterináriaRESUMO
In the present study, the possible involvement of nitric oxide (NO) in the pathogenesis of postoperative ileus was investigated indirectly by measuring nitrate, a stabile metabolite of NO. Plasma levels and 24-h urinary excretion of nitrate and nitrite were determined in the peri-operative period in three different groups of patients undergoing surgery: group 1 (LT, n=11) underwent a laparotomy, group 2 (LS, n=12) underwent a laparoscopic procedure, whereas group 3 underwent an extra-abdominal procedure (EA, n=9). Duration of postoperative ileus was assessed clinically using first occurrence of flatus and defaecation as the end of the period of ileus. Postoperative ileus lasted significantly longer in the LT group (first flatus after 3.0 [3.0-4.0] days) compared with the LS (1.0 [1.0-2.0] days) and EA (1.0 [1.0-3.0] days) groups. Urinary nitrate excretion increased significantly in the LT and EA groups during the first 24 h after surgery (from 797.0 [214.0-810.0] and 551.5 [438.3-1215.8] to 2079.0 [889.0-4644.0] and 1102.5 [315.3-1238. 0] micromol/24 h, median [IQR]), but normalized before the end of postoperative ileus. Plasma levels of nitrate were unchanged after surgery, whereas CRP levels were significantly increased in all groups (LT > LS=EA). In the first 24 h following surgery, urinary nitrate excretion is increased, suggesting increased endogenous synthesis of NO postoperatively. As no correlation was found between urinary nitrate excretion and duration of postoperative ileus, we conclude that assessment of nitrate has no value in predicting clinical outcome after surgery.
Assuntos
Obstrução Intestinal/sangue , Obstrução Intestinal/urina , Óxido Nítrico/fisiologia , Complicações Pós-Operatórias/sangue , Complicações Pós-Operatórias/urina , Proteína C-Reativa/análise , Creatinina/sangue , Dieta , Humanos , Laparoscopia , Laparotomia , Contagem de Leucócitos , Nitratos/sangue , Nitratos/urina , Nitritos/sangue , Nitritos/urina , Valor Preditivo dos TestesAssuntos
Meios de Contraste , Absorção Intestinal/efeitos dos fármacos , Obstrução Intestinal/diagnóstico por imagem , Intestinos/diagnóstico por imagem , Iohexol , Ácidos Tri-Iodobenzoicos , Cromatografia Líquida de Alta Pressão , Meios de Contraste/efeitos adversos , Meios de Contraste/análise , Método Duplo-Cego , Humanos , Obstrução Intestinal/urina , Iohexol/efeitos adversos , Iohexol/urina , Radiografia , Fatores de Tempo , Ácidos Tri-Iodobenzoicos/efeitos adversos , Ácidos Tri-Iodobenzoicos/urinaRESUMO
The impairment of fluid, electrolyte and acid-base status which is observed in calves and juvenile cattle as a result of ileus and subileus is not only dependent on form and site of the obstruction, but is also influenced considerably by the duration of the condition and any coexisting disease. This publication reviews the most important blood, urine and ruminal fluid parameters in such patients. The diagnostic significance of the laboratory values under discussion is not so great with obstructions to the caudal part of the digestive tract. However, markedly raised ruminal fluid chloride levels, combined with hypochloraemia and a metabolic acidosis, are indicative of an "abomasoruminal reflux syndrome" resulting from an obstruction in the region of the abomasum or cranial small intestine.
Assuntos
Doenças dos Bovinos/metabolismo , Obstrução Intestinal/veterinária , Equilíbrio Ácido-Base , Alcalose/veterinária , Animais , Bovinos , Doenças dos Bovinos/sangue , Doenças dos Bovinos/urina , Cloretos/análise , Eletrólitos/sangue , Concentração de Íons de Hidrogênio , Obstrução Intestinal/sangue , Obstrução Intestinal/metabolismo , Obstrução Intestinal/urina , Rúmen/química , Equilíbrio HidroeletrolíticoRESUMO
The urinary 3-methylhistidine (3-MH) and creatine excretion were measured serially in two patients on total parenteral nutrition for 201 and 225 days, respectively. Variations in excretion were related to clinical events, such as sepsis; 3-MH excretion and the 3-MH:creatinine ratio were raised in association with some episodes of infection, but not all. It is concluded that, although infection is often associated with increased myofibrillar protein breakdown, this is not always the case. It is suggested that in susceptible patients a high 3-MH:creatine ratio may indicate occult infection not detectable by other means.