Endosurgery approach in a dog with thoracoabdominal injury

Background: Chest trauma is one of the main thoracic injuries in dogs and cats, reaching a high morbidity and mortality. The tissue damage, in thoracic trauma, can be underappreciated by visual exam and traditional radiography. The thoracoscopy can provide information for a precise definitive diagnosis, by this technique bleeding or air leakage can be identified and corrected immediately and the diaphragm can be completely evaluated. The aim of this work was to describe the thoracoscopic approach in a case of diaphragmatic perforation caused by penetrating trauma in a dog. Case: A 6-year-old male dog mixed-breed dog, weighing 14 kg with thorax perforation was presented to the Veterinary Hospital. Clinical examination of the animal revealed the following: pale mucous membranes, moderate dyspnea, open pneumothorax, abdominal distension, heart rate of 108 beats per minute and respiratory rate of 64 breaths per minute. Physical examination confirmed a 3 cm perforation hemorrhagic lesion in the left ninth intercostal space. As an emergency treatment, oxygen therapy, tramadol hydrochloride [Cronidor® 2%, 4 mg/kg, i.v, TID], tranexamic acid [Transamin® 25 mg/kg, i.v, TID], ceftriaxone [Rocefin® 50 mg/kg, i.v, BID] and fluid therapy with lactated Ringer's solution were administered. The hair was removed, and then, wound cleaning and obliteration of the wall injury with sterile gauze was performed. After the emergency stabilization, the animal was anesthetized, followed by preventive thoracocentesis by an approach close to thoracic perforation and thoracoscopy without pneumoperitonea through this thoracic perforation with 0-degree rigid endoscope. About 100 mL of blood and air was drained and diagnosed perforation in the diaphragm and pulmonary atelectasis in the caudal and left cranial lobes. the edges of the incisional wound were debrided, and the closure of thoracic incision was performed usual way. After that, the air was removed by a catheter and syringe system. A flexible plastic tube was inserted through the chest wall and into the pleural space for drainage every 2 h for 24 h. There were no intercurrences during the first 24 h after the surgical procedure. The patient was discharged 48 h after the surgery. Cephalexin [75 mg, 30 mg/kg, v.o, TID, during 5 days), Ketoprofen [20 mg, 2 mg/kg, v.o, SID, during 5 days], Tramadol Hydrochloride [50 mg, 4 mg/kg, v.o, SID, during 2 days] and Rifamycin spray at the wound site was prescribed. Ten days after surgery, the patient returned to the hospital for suture removal and reassessment. Discussion: The prognosis of chest perforation depends on the severity and number of internal and external thoracic lesions, as well as cardiovascular status at the time of initial patient care. In cases of penetrating chest trauma, it is essential to thoroughly examine the thoracic cavity for bleeding, tissue tears, and diaphragm perforation. The use of the endoscope allowed for a more detailed exploration of the chest without the need to increase the incision. When the diaphragm lesion was found, it was also possible to perform the abdominal examination by videoendoscopy, through this perforation. Laparotomy and thoracotomy cause postoperative pain and discomfort, in addition to increasing recovery time, however, even with trauma, not performing a larger incision favored the recovery of this patient, without any intercurrence in the first 24 h after the procedure. In conclusion, the endoscopic approach was efficient for diagnosis, avoiding greater trauma and contributing to a better clinical recovery of the patient.

Intra-abdominal hypertension secondary to chronic diaphragmatic rupture in a dog / Hipertensão intra-abdominal secundária à ruptura diafragmática crônica em um cão

Intra-abdominal hypertension (IAH) is the persistent increase of intra-abdominal pressure (IAP) that could be caused by several pathologies. It is capable of promoting organ dysfunction, thereby increasing the mortality rate of human patients. As for cats and dogs, there are still few reports on how this pressure can be monitored and treated as a routine for admitted and hospitalized animals and on its relationship with the mortality of the patients. Therefore, the objective of this paper was to report a case of IAH secondary to chronic diaphragmatic rupture in a dog, which was treated with a temporary abdominal closure (TAC). A bitch was admitted to the veterinary hospital to undergo an elective ovariohysterectomy when it was diagnosed with a diaphragmatic rupture and displacement of the liver and intestinal loops in the chest. After repositioning these structures in the abdominal cavity, tension was observed in the abdomen. A temporary abdominal closure was then performed with a Bogota bag. Immediately after the surgery, the IAP was measured, presenting a value of 15 mmHg, indicating that there was an increase in intra-abdominal pressure. The animal was hospitalized, and IAP was monitored. After 24 hours, IAP was 5.8 mmHg when the Bogota bag was removed, and definitive celiorraphy was performed. The patient showed satisfactory clinical progress and was discharged 72 hours after the surgical procedure. The treatment used for IAH proved to be effective and contributed to the quick and satisfactory recovery of the patient.

A hipertensão intra-abdominal (HIA) é o aumento persistente da pressão intra-abdominal (PIA), podendo ser causada por diversas afecções e caraterizada por promover disfunções orgânicas, aumentando a taxa de mortalidade no homem. Em cães e gatos, ainda há poucos relatos da monitoração dessa pressão e do seu tratamento na rotina dos animais admitidos e internados, e sua relação com a mortalidade dos pacientes. Assim, objetivou-se relatar um caso de HIA secundária à ruptura diafragmática crônica em cão, a qual foi tratada com o fechamento abdominal temporário (FAT). Uma cadela foi admitida no hospital veterinário para realização de uma cirurgia de ovário-histerectomia eletiva, quando foi diagnosticada com ruptura diafragmática com fígado e alças intestinais deslocadas para o interior do tórax. Após reposicionamento dessas estruturas na cavidade abdominal, observou-se tensão no abdômen. Realizou-se então o fechamento abdominal temporário com bolsa de Bogotá. Imediatamente após o término da cirurgia, a PIA foi aferida e seu valor era de 15 mmHg, indicando aumento da mesma. O animal foi mantido internado e sua PIA monitorada. Após 24 horas seu valor era de 5,8 mmHg, quando a bolsa de Bogotá foi removida e realizada a celiorrafia definitiva. O paciente teve evolução clínica satisfatória e 72h após a cirurgia recebeu alta hospitalar. O tratamento utilizado para a HIA se mostrou eficaz, contribuindo para a rápida e satisfatória recuperação da paciente.

Intra-abdominal hypertension secondary to chronic diaphragmatic rupture in a dog / Hipertensão intra-abdominal secundária à ruptura diafragmática crônica em um cão

Intra-abdominal hypertension (IAH) is the persistent increase of intra-abdominal pressure (IAP) that could be caused by several pathologies. It is capable of promoting organ dysfunction, thereby increasing the mortality rate of human patients. As for cats and dogs, there are still few reports on how this pressure can be monitored and treated as a routine for admitted and hospitalized animals and on its relationship with the mortality of the patients. Therefore, the objective of this paper was to report a case of IAH secondary to chronic diaphragmatic rupture in a dog, which was treated with a temporary abdominal closure (TAC). A bitch was admitted to the veterinary hospital to undergo an elective ovariohysterectomy when it was diagnosed with a diaphragmatic rupture and displacement of the liver and intestinal loops in the chest. After repositioning these structures in the abdominal cavity, tension was observed in the abdomen. A temporary abdominal closure was then performed with a Bogota bag. Immediately after the surgery, the IAP was measured, presenting a value of 15 mmHg, indicating that there was an increase in intra-abdominal pressure. The animal was hospitalized, and IAP was monitored. After 24 hours, IAP was 5.8 mmHg when the Bogota bag was removed, and definitive celiorraphy was performed. The patient showed satisfactory clinical progress and was discharged 72 hours after the surgical procedure. The treatment used for IAH proved to be effective and contributed to the quick and satisfactory recovery of the patient.(AU)

A hipertensão intra-abdominal (HIA) é o aumento persistente da pressão intra-abdominal (PIA), podendo ser causada por diversas afecções e caraterizada por promover disfunções orgânicas, aumentando a taxa de mortalidade no homem. Em cães e gatos, ainda há poucos relatos da monitoração dessa pressão e do seu tratamento na rotina dos animais admitidos e internados, e sua relação com a mortalidade dos pacientes. Assim, objetivou-se relatar um caso de HIA secundária à ruptura diafragmática crônica em cão, a qual foi tratada com o fechamento abdominal temporário (FAT). Uma cadela foi admitida no hospital veterinário para realização de uma cirurgia de ovário-histerectomia eletiva, quando foi diagnosticada com ruptura diafragmática com fígado e alças intestinais deslocadas para o interior do tórax. Após reposicionamento dessas estruturas na cavidade abdominal, observou-se tensão no abdômen. Realizou-se então o fechamento abdominal temporário com bolsa de Bogotá. Imediatamente após o término da cirurgia, a PIA foi aferida e seu valor era de 15 mmHg, indicando aumento da mesma. O animal foi mantido internado e sua PIA monitorada. Após 24 horas seu valor era de 5,8 mmHg, quando a bolsa de Bogotá foi removida e realizada a celiorrafia definitiva. O paciente teve evolução clínica satisfatória e 72h após a cirurgia recebeu alta hospitalar. O tratamento utilizado para a HIA se mostrou eficaz, contribuindo para a rápida e satisfatória recuperação da paciente.(AU)

Bloqueio do plano transverso do abdômen guiado por ultrassom em felino submetido a mastectomia regional / Blocking of the abdomen transverse plan guided by ultrasound in feline submitted to regional mastectomy

Os bloqueios locorregionais vêm sendo cada vez mais utilizados na medicina veterinária. O bloqueio do plano transverso do abdômen (TAP Block) é uma técnica de anestesia locorregional, faz parte da estratégia de analgesia multimodal, capaz de promover anestesia e analgesia em regiões de pele, musculatura e peritônio parietal. O objetivo deste trabalho é relatar o bloqueio do plano transverso em um felino macho de dois anos de idade submetido a mastectomia regional. Foram feitos dois pontos de bloqueio do espaço TAP guiado por ultrassom, em cada lado do abdômen: um na parte caudal da região abdominal média, cranial a crista ilíaca, e o outro ponto, caudal a última costela, com 0,5mg/kg de bupivacaína a 0,25% em cada ponto, padronizando um volume injetado de 0,6mL. Foi utilizado acepromazina (0,05mg/kg), petidina (3mg/kg), cetamina (2mg/kg) e midazolam (0,3mg/kg) como medicação pré-anestésica, indução com propofol (3mg/kg) e manutenção por anestesia inalatória com isoflurano. Conclui-se que o TAP block foi eficaz para mastectomia regional abdominal, com alto índice de segurança e de fácil execução com treinamento adequado, mesmo com transdutores de baixa frequência.

Locoregional blocks have been increasingly used in veterinary medicine. Blocking the transverse plane of the abdomen (TAP Block) is a technique of locoregional anesthesia, it is part of the multimodal analgesia strategy, capable of promoting anesthesia and analgesia in regions of skin, musculature and parietal peritoneum. The aim of this study is to report the transverse plane block in a two-year-old male cat undergoing regional mastectomy. Two ultrasound-guided TAP space block points were made on each side of the abdomen: one in the caudal part of the middle abodminal region, cranial to the iliac crest, and the other point, caudal to the last rib, with 0.5mg/kg of 0.25% bupivacaine at each point, standardizing an injected volume of 0.6mL. Acepromazine (0.05mg/kg), pethidine (3mg/kg), ketamine (2mg/kg) and midazolam (0.3mg/kg) were used as pre-anesthetic medication, induction with propofol (3mg/kg) and maintenance by inhalation anesthesia with isoflurane. It is concluded that the TAP block was effective for regional abdominal mastectomy, with a high safety index and easy to perform with adequate training, even with less frequent transducers.

Eventração paracostal de útero gravídico em cadela / Paracostal eventration of a pregnant uterus in a bitch

Background: Traumatic abdominal hernias result from trauma which causes muscular and fascia rupture, with dislocation of viscera into the subcutaneous space without perforation of the skin. Paracostal eventration, occurs due to avulsion of the abdominal external oblique and abdominal transverse muscles from their insertion point at the ribs, resulting in dislocation of the abdominal viscera into the subcutaneous region, lateral to the abdominal wall; however, there are few reports in the literature describing this type of lesion in dogs, especially when the herniated content is a gravid uterus. The purpose of this paper is to report a case of traumatic paracostal hernia of a pregnant uterus in a dog. Case: A 2-year-old pregnant bitch weighing 8.9 kg was presented with a sudden increase in abdominal volume lateral to the left thoracic wall which, according to the owner, started after the dog was hit by a car. On physical examination, the dog had a greenish vaginal secretion and the increased volume on the left paracostal region mentioned above. Laboratory exams showed normocytic normochromic anemia, slight leukocytosis without left shift, and a discreet increase in creatinine, urea, and alanine aminotransferase. Abdominal radiographs showed a lack of continuity of the left abdominal muscle wall, with passage of the uterine horn into the subcutaneous space lateral to the rib cage. After stabilization of the patient with fluid therapy and analgesia, the bitch was anesthetized with propofol intravenously, and maintained with isoflurane diluted in oxygen. Cephazolin was administered intravenously 30 min prior to the surgery as prophylactic antibiotic therapy. An exploratory celiotomy was then performed, where a defect in the internal and external oblique abdominal muscles and transverse abdominal muscle was observed at their point of origin and insertion at the...

Eventração paracostal de útero gravídico em cadela / Paracostal eventration of a pregnant uterus in a bitch

Background: Traumatic abdominal hernias result from trauma which causes muscular and fascia rupture, with dislocation of viscera into the subcutaneous space without perforation of the skin. Paracostal eventration, occurs due to avulsion of the abdominal external oblique and abdominal transverse muscles from their insertion point at the ribs, resulting in dislocation of the abdominal viscera into the subcutaneous region, lateral to the abdominal wall; however, there are few reports in the literature describing this type of lesion in dogs, especially when the herniated content is a gravid uterus. The purpose of this paper is to report a case of traumatic paracostal hernia of a pregnant uterus in a dog. Case: A 2-year-old pregnant bitch weighing 8.9 kg was presented with a sudden increase in abdominal volume lateral to the left thoracic wall which, according to the owner, started after the dog was hit by a car. On physical examination, the dog had a greenish vaginal secretion and the increased volume on the left paracostal region mentioned above. Laboratory exams showed normocytic normochromic anemia, slight leukocytosis without left shift, and a discreet increase in creatinine, urea, and alanine aminotransferase. Abdominal radiographs showed a lack of continuity of the left abdominal muscle wall, with passage of the uterine horn into the subcutaneous space lateral to the rib cage. After stabilization of the patient with fluid therapy and analgesia, the bitch was anesthetized with propofol intravenously, and maintained with isoflurane diluted in oxygen. Cephazolin was administered intravenously 30 min prior to the surgery as prophylactic antibiotic therapy. An exploratory celiotomy was then performed, where a defect in the internal and external oblique abdominal muscles and transverse abdominal muscle was observed at their point of origin and insertion at the...(AU)

Complicações multissistêmicas decorrentes de hérnia inguino-escrotal em equino / Multisystemic complications due to inguinal hernia in a horse

O presente trabalho teve como objetivo descrever complicaçoes multissistêmicas associadas à hernia inguino-escrotal em equino. Um equino da raça Brasileiro de Hipismo, de 7 anos, foi encaminhado para atendimento veterinário apresentando dor abdominal moderada, desidrataçao severa e sinais de síndrome da resposta inflamatória sistêmica (SIRS). Indicou-se laparotomia e a hernia inguino-escrotal foi corrigida. Entretanto houve necessidade de uma segunda laparotomia realizada seis dias após a primeira intervenção cirúrgica devido aos sinais de dor e refluxo incessantes. No momento da admissão o animal já apresentava sinais de SIRS e no pós operatório apresentou íleo adinâmico, insuficiência renal aguda e duodeno-jejunite proximal, além de complicações respiratórias e disfagia. Ao final o animal se recuperou de todas essas complicações, porém desenvolveu laminite e acabou sendo eutanasiado devido à posição permanente de decúbito.

The aim of the present study was to describe multisystemic complications associated with inguinal hernia in a horse. A 7-year-old Brazilian-saddle horse was referred to veterinary care with moderate abdominal pain, severe dehydration and signs of systemic inflammatory response syndrome (SIRS). A laparotomy was indicated and the condition was treated. However, a second laparotomy was required six days after due to incessant pain and reflux. Upon admission the animal had signs of SIRS and showed adynamic ileus, acute renal failure and proximal duodenum-jejunitis during the postoperative period, in addition to respiratory complications and dysphagia. The horse recovered from all these complications but developed laminits and euthanasia was elected due to permanent decubitus.

Complicações multissistêmicas decorrentes de hérnia inguino-escrotal em equino / Multisystemic complications due to inguinal hernia in a horse

O presente trabalho teve como objetivo descrever complicaçoes multissistêmicas associadas à hernia inguino-escrotal em equino. Um equino da raça Brasileiro de Hipismo, de 7 anos, foi encaminhado para atendimento veterinário apresentando dor abdominal moderada, desidrataçao severa e sinais de síndrome da resposta inflamatória sistêmica (SIRS). Indicou-se laparotomia e a hernia inguino-escrotal foi corrigida. Entretanto houve necessidade de uma segunda laparotomia realizada seis dias após a primeira intervenção cirúrgica devido aos sinais de dor e refluxo incessantes. No momento da admissão o animal já apresentava sinais de SIRS e no pós operatório apresentou íleo adinâmico, insuficiência renal aguda e duodeno-jejunite proximal, além de complicações respiratórias e disfagia. Ao final o animal se recuperou de todas essas complicações, porém desenvolveu laminite e acabou sendo eutanasiado devido à posição permanente de decúbito.(AU)

The aim of the present study was to describe multisystemic complications associated with inguinal hernia in a horse. A 7-year-old Brazilian-saddle horse was referred to veterinary care with moderate abdominal pain, severe dehydration and signs of systemic inflammatory response syndrome (SIRS). A laparotomy was indicated and the condition was treated. However, a second laparotomy was required six days after due to incessant pain and reflux. Upon admission the animal had signs of SIRS and showed adynamic ileus, acute renal failure and proximal duodenum-jejunitis during the postoperative period, in addition to respiratory complications and dysphagia. The horse recovered from all these complications but developed laminits and euthanasia was elected due to permanent decubitus.(AU)

Combination of Transversus abdominis plane block and Serratus plane block anesthesia in dogs submitted to masctetomy / Combinação dos bloqueios anestésicos do plano transverso abdominal e do plano serrátil em cadelas submetidas à mastectomia

This paper pretends to demonstrate the effect of the combination of transversus abdominis plane block (TAP block) and Serratus plane block (SP block) techniques in analgesia of 4 dogs undergoing total unilateral mastectomy. Dogs were premedicated with methadone (0.5mg.kg-1) intramuscularly. Anesthesia was induced with propofol (6mg.kg-1) and midazolam (0.3mg.kg-1) and maintained with isoflurane. SP and TAP block were performed unilaterally using ultrasound by the injection of bupivacaine 0.25% (0.3mL kg-1) diluted with NaCl solution 1:1. Heart rate (HR), respiratory rate (f), non-invasive arterial pressure, esophageal temperature (T), oxygen saturation (SpO2) and electrocardiogram were monitored continuously. Animals were monitored for two and four hours after extubation for pain by using the Canine Acute Pain Scale from Colorado State University. Two hours after extubation, tramadol (4mg.kg-1) and dipyrone (25mg.kg-1) was administered to all dogs. It was not observed any alteration on cardiac rhythm. HR, f, T and mean arterial pressure remained below the preincisional values for all dogs. No dog required intraoperative rescue analgesia. Recovery from anesthesia was without any complication. All animals scored 0 (0/5) at pain scale, two and four hours after extubation and none of them expressed concern over the surgical wound. Dogs were able to walk before two hours after extubation. The combination of both techniques is effective in anesthetic blocking the thoracic and abdominal walls and it is suggested both may be included in the multimodal analgesia protocols for this type of surgery.(AU)

Este trabalho pretende demonstrar o efeito analgésico da combinação das técnicas de bloqueio do plano transverso abdominal (TAP block) e bloqueio do plano serrátil (SP block) em 4 cadelas submetidas à mastectomia unilateral total. Os animais foram pré-medicados com metadona (0,5mg.kg-1) por via intramuscular. A anestesia foi induzida com propofol (6mg.kg-1) e midazolam (0,3mg.kg-1) e mantida com isoflurano. Os bloqueios SP e TAP foram realizados unilateralmente, utilizando ultrassonografia, pela injeção de bupivacaína a 0,25% (0,3mL.kg-1), diluída com solução de NaCl a 1:1. A frequência cardíaca (FC), frequência respiratória (f), pressão arterial não invasiva, temperatura esofágica (T), saturação de oxigênio (SpO2) e eletrocardiograma foram monitorados continuamente. Os animais foram monitorizados durante duras e quatro horas após a extubação para a dor usando a Escala de Dor Aguda Canina da Universidade Estadual do Colorado. Duas horas após a extubação, tramadol (4mg.kg-1) e dipirona (25mg.kg-1) foram administrados a todos os cães. Não foi observada qualquer alteração no ritmo cardíaco. HR, f, T e pressão arterial média permaneceram abaixo dos valores basais para todos os cães. Nenhum cão requereu resgate analgésico intra-operatório. Não houve complicações na recuperação anestésica. Todos os animais apresentaram escore 0 (0/5) na escala de dor, duras e 4 quatro horas após a extubação e nenhum expressou desconforto com a ferida cirúrgica. Todos os cães foram capazes de caminhar antes de duas horas após extubação. A combinação de ambas as técnicas é eficaz no bloqueio anestésico das paredes torácica e abdominal e sugere-se que ambos podem ser incluídos nos protocolos de analgesia multimodal para este tipo de cirurgia.(AU)

Combination of Transversus abdominis plane block and Serratus plane block anesthesia in dogs submitted to masctetomy / Combinação dos bloqueios anestésicos do plano transverso abdominal e do plano serrátil em cadelas submetidas à mastectomia

This paper pretends to demonstrate the effect of the combination of transversus abdominis plane block (TAP block) and Serratus plane block (SP block) techniques in analgesia of 4 dogs undergoing total unilateral mastectomy. Dogs were premedicated with methadone (0.5mg.kg-1) intramuscularly. Anesthesia was induced with propofol (6mg.kg-1) and midazolam (0.3mg.kg-1) and maintained with isoflurane. SP and TAP block were performed unilaterally using ultrasound by the injection of bupivacaine 0.25% (0.3mL kg-1) diluted with NaCl solution 1:1. Heart rate (HR), respiratory rate (f), non-invasive arterial pressure, esophageal temperature (T), oxygen saturation (SpO2) and electrocardiogram were monitored continuously. Animals were monitored for two and four hours after extubation for pain by using the Canine Acute Pain Scale from Colorado State University. Two hours after extubation, tramadol (4mg.kg-1) and dipyrone (25mg.kg-1) was administered to all dogs. It was not observed any alteration on cardiac rhythm. HR, f, T and mean arterial pressure remained below the preincisional values for all dogs. No dog required intraoperative rescue analgesia. Recovery from anesthesia was without any complication. All animals scored 0 (0/5) at pain scale, two and four hours after extubation and none of them expressed concern over the surgical wound. Dogs were able to walk before two hours after extubation. The combination of both techniques is effective in anesthetic blocking the thoracic and abdominal walls and it is suggested both may be included in the multimodal analgesia protocols for this type of surgery.(AU)

Este trabalho pretende demonstrar o efeito analgésico da combinação das técnicas de bloqueio do plano transverso abdominal (TAP block) e bloqueio do plano serrátil (SP block) em 4 cadelas submetidas à mastectomia unilateral total. Os animais foram pré-medicados com metadona (0,5mg.kg-1) por via intramuscular. A anestesia foi induzida com propofol (6mg.kg-1) e midazolam (0,3mg.kg-1) e mantida com isoflurano. Os bloqueios SP e TAP foram realizados unilateralmente, utilizando ultrassonografia, pela injeção de bupivacaína a 0,25% (0,3mL.kg-1), diluída com solução de NaCl a 1:1. A frequência cardíaca (FC), frequência respiratória (f), pressão arterial não invasiva, temperatura esofágica (T), saturação de oxigênio (SpO2) e eletrocardiograma foram monitorados continuamente. Os animais foram monitorizados durante duras e quatro horas após a extubação para a dor usando a Escala de Dor Aguda Canina da Universidade Estadual do Colorado. Duas horas após a extubação, tramadol (4mg.kg-1) e dipirona (25mg.kg-1) foram administrados a todos os cães. Não foi observada qualquer alteração no ritmo cardíaco. HR, f, T e pressão arterial média permaneceram abaixo dos valores basais para todos os cães. Nenhum cão requereu resgate analgésico intra-operatório. Não houve complicações na recuperação anestésica. Todos os animais apresentaram escore 0 (0/5) na escala de dor, duras e 4 quatro horas após a extubação e nenhum expressou desconforto com a ferida cirúrgica. Todos os cães foram capazes de caminhar antes de duas horas após extubação. A combinação de ambas as técnicas é eficaz no bloqueio anestésico das paredes torácica e abdominal e sugere-se que ambos podem ser incluídos nos protocolos de analgesia multimodal para este tipo de cirurgia.(AU)

Impacts of albumin synergized with hydroxyethyl starch on early microvascular albumin leakage after major abdominal surgery in rabbits

Purpose: To investigate the impacts of albumin synergized with hydroxyethyl starch (HES) on early microvascular albumin leakage after major abdominal surgery in rabbits. Methods: Forty male Japanese rabbits were randomly divided into four groups: the control group, the saline group, the albumin group, and the Syn group (hydroxyethyl starch+albumin). The latter three groups were performed gastrectomy plus resection of pancreatic body and tail and splenectomy. The serum albumin concentration was detected before and 48h after surgery, and the conditions of mesenteric microvascular leakage in these 4 groups were observed under microscope 48 h after surgery to calculate the leakage rate. Results: Compared with the saline group, the albumin group and the Syn group exhibited significantly increased serum albumin concentrations 48h after surgery (P 0.05). The albumin leakage rate was the most obvious in the albumin group, followed by the saline group, while that in the Syn group was the minimal, and there existed significant differences among these groups (P 0.05) . Conclusion: Simple administration of albumin in the early stage after major abdominal surgery could increase the albumin leakage, while the synergization of albumin and hydroxyethyl starch could reduce the albumin leakage.(AU)

Reparo de lesão penetrante em parede torácica de cão, ocasionada por javali (Sus scrofa scrofa), com flape unipediculado de músculo reto abdominal / Unipediculated flap of muscle rectos abdominales to repair a penetrating injury caused by javali (Sus scrofa scrofa) on the thoracic wall of a dog

Lesões penetrantes no tórax causadas por interação animal são frequentes em cães e caracterizam-se por dano extenso e desvitalização dos tecidos moles adjacentes. Quando a musculatura local é insuficiente para a reconstrução, retalhos musculares podem ser mobilizados para reparar o defeito torácico. O presente relato tem como objetivo demonstrar uma alternativa para o reparo de defeito da parede torácica em um cão, ocasionada por interação com javali (Sus scrofa scrofa), utilizando flape unipediculado de músculo reto abdominal. Com base na literatura consultada, essa técnica reconstrutiva ainda não foi descrita. O flape de músculo reto abdominal mostrou-se uma alternativa viável no reparo de lesão extensa e infectada na parede torácica em cães.(AU)

Penetrating thoracic wounds caused by animal bites are common in dogs and are characterized by extensive trauma and adjacent soft tissue devitalization. When the local musculature is insufficient for the reconstruction, muscle flaps can be taken to repair the thoracic defect. The aim of the present report is to demonstrate an alternative to the thoracic wall defect repair in a dog which was attacked by javali (Sus scrofa scrofa), using unipediculated flap of the rectus abdominis muscle. Based on the literature, this reconstructive technique has not yet been described. The rectus abdominis muscle flap proves to be a useful alternative for the repair of extensive and infected thoracic wall lesion in dogs.(AU)

Reparo de lesão penetrante em parede torácica de cão, ocasionada por javali (Sus scrofa scrofa), com flape unipediculado de músculo reto abdominal / Unipediculated flap of muscle rectos abdominales to repair a penetrating injury caused by javali (Sus scrofa scrofa) on the thoracic wall of a dog

Lesões penetrantes no tórax causadas por interação animal são frequentes em cães e caracterizam-se por dano extenso e desvitalização dos tecidos moles adjacentes. Quando a musculatura local é insuficiente para a reconstrução, retalhos musculares podem ser mobilizados para reparar o defeito torácico. O presente relato tem como objetivo demonstrar uma alternativa para o reparo de defeito da parede torácica em um cão, ocasionada por interação com javali (Sus scrofa scrofa), utilizando flape unipediculado de músculo reto abdominal. Com base na literatura consultada, essa técnica reconstrutiva ainda não foi descrita. O flape de músculo reto abdominal mostrou-se uma alternativa viável no reparo de lesão extensa e infectada na parede torácica em cães.(AU)

Penetrating thoracic wounds caused by animal bites are common in dogs and are characterized by extensive trauma and adjacent soft tissue devitalization. When the local musculature is insufficient for the reconstruction, muscle flaps can be taken to repair the thoracic defect. The aim of the present report is to demonstrate an alternative to the thoracic wall defect repair in a dog which was attacked by javali (Sus scrofa scrofa), using unipediculated flap of the rectus abdominis muscle. Based on the literature, this reconstructive technique has not yet been described. The rectus abdominis muscle flap proves to be a useful alternative for the repair of extensive and infected thoracic wall lesion in dogs.(AU)

Laparoscopic-assisted approach to the pelvic flexure for surgical treatment of sand impaction in a horse

Background: Laparoscopy provides good visualization of horses abdominal cavity, besides providing minimal invasiveness and meticulous manipulation intra-abdominal organs. Laparoscopy is suitable for both diagnosing and treating acute abdomen in horses. The purpose of this study was to report a successful case of laparoscopic-assisted surgery for treating sand impaction in a horse.Case: A 3-year-old horse, weighing 460 kg, was admitted following chronic intermittent episodes of diarrhea and colic. Physical exam revealed mild abdominal pain and liquid/pasty diarrhea. There was negative survey of gastrointestinal helminthes and microbiological analyses. Fecal sedimentation test revealed sand impaction. Surgical approach was opted for both accomplishment of the abdominal exploration and resolution of the impactation. The patient was anesthetized and positioned in dorsal recumbency. Laparoscopy was performed through an 11-mm trocar placed right cranially to the umbilicus. There were no apparent adhesions, bowel inflammation nor visceral displacement. A 15-cm celiotomy was carried out caudally to the umbilicus, under laparoscopic guidance, for initial inspection of the gastrointestinal tract. Incision enlargement was required for exteriorizing the pelvic flexure. Afterwards, enterotomy was carried out for drainage of the impactating content, followed by enterorraphy. The pelvic flex...(AU)

Laparoscopic-assisted approach to the pelvic flexure for surgical treatment of sand impaction in a horse

Background: Laparoscopy provides good visualization of horses abdominal cavity, besides providing minimal invasiveness and meticulous manipulation intra-abdominal organs. Laparoscopy is suitable for both diagnosing and treating acute abdomen in horses. The purpose of this study was to report a successful case of laparoscopic-assisted surgery for treating sand impaction in a horse.Case: A 3-year-old horse, weighing 460 kg, was admitted following chronic intermittent episodes of diarrhea and colic. Physical exam revealed mild abdominal pain and liquid/pasty diarrhea. There was negative survey of gastrointestinal helminthes and microbiological analyses. Fecal sedimentation test revealed sand impaction. Surgical approach was opted for both accomplishment of the abdominal exploration and resolution of the impactation. The patient was anesthetized and positioned in dorsal recumbency. Laparoscopy was performed through an 11-mm trocar placed right cranially to the umbilicus. There were no apparent adhesions, bowel inflammation nor visceral displacement. A 15-cm celiotomy was carried out caudally to the umbilicus, under laparoscopic guidance, for initial inspection of the gastrointestinal tract. Incision enlargement was required for exteriorizing the pelvic flexure. Afterwards, enterotomy was carried out for drainage of the impactating content, followed by enterorraphy. The pelvic flex...

Analysis of effect isoxsuprine hydrochloride and nicotine in the Transverse Rectus Abdominis Myocutaneous flap (TRAM) in rats

PURPOSE: To evaluate the effects of isoxsuprine and nicotine on TRAM. METHODS: Forty eight 48 Wistar rats distributed into four Groups (n=12). All rats received medication managed daily for 20 days: saline solution (SA), nicotine solution (NI), isoxsuprine solution (IS) and nicotine solution (NI) + isoxsuprine solution (IS). On day 21st the rats were submitted to the caudally based, right unipedicled TRAM flap and after 48 hours, made the macroscopic evaluation of the surface of the flap, photographic documentation and collection of material for histology. Data from macroscopic evaluation were analyzed by ANOVA and microscopic evaluation by Kruskal-Wallis test, with significance level of 5%. RESULTS: In the macroscopic evaluation of isoxsuprine Group retail presented absolute numbers: final area (p=0.001*) and viable area (p=0.006*) with the highest values; necrosis (p=0.001*) had the lowest value. Microscopic examination revealed no significant findings in the study of TRAM under the action of isoxsuprine and nicotine to the percentage of necrosis in the left and right cranial and caudal regions. CONCLUSIONS: There was significant improvement in viability of TRAM using the isoxsuprine solution alone. No influence using nicotine alone and in association with isoxsuprine.(AU)

Hérnia diafragmática traumática em felino / Diaphragmatic traumatic hernia in feline

As hérnias diafragmáticas caracterizam-se pela passagem das vísceras abdominais para a cavidade torácica após ruptura do diafragma (FOSSUM et al., 2007). Normalmente as hérnias diafragmáticas tem origem traumática (DALECK et al., 2008), podendo também ser de caráter congênito (MAZZANTI et al., 2003). Os sintomas relacionam-se com alterações gastrointestinais e respiratórias, sendo a dispneia o distúrbio mais mencionado (DRUMOND et al., 2007). O diagnóstico fundamenta-se, especialmente, na história do paciente que geralmente coincide com trauma, decorrente de acidentes automobilísticos, quedas, chutes e brigas (FOSSUM et al., 2007), e sinais clínicos apresentados, porém o exame radiográfico é primordial para o diagnóstico conclusivo (ARAGÃO et al., 2010). Com esse trabalho objetivou-se relatar um caso de hérnia diafragmática adquirida em felino após traumatismo, submetido ao tratamento cirúrgico, o qual desencadeou parada cardiorrespiratória com necessidade de atendimento emergencial.

Evisceração por acidente automobilístico em cão da raça pitbull / Evisceration by car accident in dog pitbull

Foi atendido no Hospital de Clínicas Veterinária da UFRGS um canino da raça Pitbull, de aproximadamente cinco anos e pesando 40 kg. O animal apresentava evisceração de diversos órgãos abdominais devido a atropelamento, além de choque hipovolêmico.

Evisceração por acidente automobilístico em cão da raça pitbull / Evisceration by car accident in dog pitbull

Foi atendido no Hospital de Clínicas Veterinária da UFRGS um canino da raça Pitbull, de aproximadamente cinco anos e pesando 40 kg. O animal apresentava evisceração de diversos órgãos abdominais devido a atropelamento, além de choque hipovolêmico.(AU)

Hérnia diafragmática traumática em felino / Diaphragmatic traumatic hernia in feline

As hérnias diafragmáticas caracterizam-se pela passagem das vísceras abdominais para a cavidade torácica após ruptura do diafragma (FOSSUM et al., 2007). Normalmente as hérnias diafragmáticas tem origem traumática (DALECK et al., 2008), podendo também ser de caráter congênito (MAZZANTI et al., 2003). Os sintomas relacionam-se com alterações gastrointestinais e respiratórias, sendo a dispneia o distúrbio mais mencionado (DRUMOND et al., 2007). O diagnóstico fundamenta-se, especialmente, na história do paciente que geralmente coincide com trauma, decorrente de acidentes automobilísticos, quedas, chutes e brigas (FOSSUM et al., 2007), e sinais clínicos apresentados, porém o exame radiográfico é primordial para o diagnóstico conclusivo (ARAGÃO et al., 2010). Com esse trabalho objetivou-se relatar um caso de hérnia diafragmática adquirida em felino após traumatismo, submetido ao tratamento cirúrgico, o qual desencadeou parada cardiorrespiratória com necessidade de atendimento emergencial.(AU)