Evaluation of the acid-neutralizing and cytotoxicity properties of novel plant mucilage used as an alternative treatment for peptic ulcers and as antacids in Namibia

Hypersecretion of gastric acid damages the stomach lining, causing the formation of peptic ulcers. Mucilage from medicinal plants offers a relaxing and soothing effect to the endodermal lining of the gut and has antacid properties, which can protect the mucosal lining from gastric acidity. This is the first report aimed to evaluate the physicochemical characteristics, acid-neutralizing, and cytotoxicity properties of traditionally used aqueous mucilage from Asparagus exuvialis and Sesamum capense. The physicochemical properties were determined by biochemical methods. Acid neutralizing and buffering capacities were determined by titration methods. Normal mouse embryonic fibroblast cells were used for cytotoxicity evaluation by MTT assay. The physicochemical characterization confirmed the presence of carbohydrates, alkaloids, saponins, proteins, tannins, flavonoids, and glycosides. Sesamum capense mucilage exhibited the most potent artificial gastric juice neutralizing capacity pH of 4.62±0.01, 8.0±0.00 acid neutralization capacity per gram of acid, and 30 minutes duration of acid neutralization. The aqueous mucilage from S. capense did not cause any significant cytotoxicity to 3T3 cell lines showing an IC50 value of 91.5 ± 0.06 µg mL-1, confirming the safe nature of the mucilage. These findings revealed that S. capense has the potential to neutralize gastric acid responsible for ulceration and can be safely consumed.(AU)

Partial obstruction and intestinal bleeding secondary to a congenital duodenal diverticulum in a dog

Background: Intestinal diverticulum is an abnormality resulting in the formation of a blind-ended saccular pouch that canbe acquired either congenital, true (involving all intestinal layers) or false (involving the mucosa and submucosa), withextraluminal and intraluminal type. In humans, the acquired is more frequent, the colon is the most affected segment followed by duodenum; and majority cases of duodenal diverticula remains asymptomatic, but biliary obstruction, recurrentacute pancreatitis, hemorrhagic ulcer, proximal intestinal obstruction and perforation may occur. The aim of this report isto present a case of a congenital disease in dogs, prone to misdiagnosis due to non-specific clinical signs.Case: An 8-month-old male Boxer was evaluated due to recurrent hyporexia, vomiting, melena and syncope over threemonths with signs of a possible intestinal obstruction. Physical examination showed no abnormalities except for palemucous membranes. Complete blood count revealed anemia and leukocytosis. Platelets and biochemical profiles werenormal. Abdominal ultrasound examination indicated a dilated duodenum, measuring approximately 3.36 cm in diameter,with heterogeneous fluid content and hyperechoic structures with acoustic shadow, peristalsis appeared decreased andnon-progressive. The gastrointestinal positive contrast study was performed to better evaluate abnormalities detected atultrasonography. Images after 30 min of contrast administration demonstrated a marked distension of the duodenum, filledwith contrast and a mildly filled stomach displaced to the left. Sixty min after contrast administration a marked distensionof the entire duodenum, with tortuous aspect and filled with contrast was seen. The caudal duodenal flexure was connectedto a large barium filled saccular structure that measured approximately 7 cm in diameter...

Partial obstruction and intestinal bleeding secondary to a congenital duodenal diverticulum in a dog

Background: Intestinal diverticulum is an abnormality resulting in the formation of a blind-ended saccular pouch that canbe acquired either congenital, true (involving all intestinal layers) or false (involving the mucosa and submucosa), withextraluminal and intraluminal type. In humans, the acquired is more frequent, the colon is the most affected segment followed by duodenum; and majority cases of duodenal diverticula remains asymptomatic, but biliary obstruction, recurrentacute pancreatitis, hemorrhagic ulcer, proximal intestinal obstruction and perforation may occur. The aim of this report isto present a case of a congenital disease in dogs, prone to misdiagnosis due to non-specific clinical signs.Case: An 8-month-old male Boxer was evaluated due to recurrent hyporexia, vomiting, melena and syncope over threemonths with signs of a possible intestinal obstruction. Physical examination showed no abnormalities except for palemucous membranes. Complete blood count revealed anemia and leukocytosis. Platelets and biochemical profiles werenormal. Abdominal ultrasound examination indicated a dilated duodenum, measuring approximately 3.36 cm in diameter,with heterogeneous fluid content and hyperechoic structures with acoustic shadow, peristalsis appeared decreased andnon-progressive. The gastrointestinal positive contrast study was performed to better evaluate abnormalities detected atultrasonography. Images after 30 min of contrast administration demonstrated a marked distension of the duodenum, filledwith contrast and a mildly filled stomach displaced to the left. Sixty min after contrast administration a marked distensionof the entire duodenum, with tortuous aspect and filled with contrast was seen. The caudal duodenal flexure was connectedto a large barium filled saccular structure that measured approximately 7 cm in diameter...(AU)

Gastrointestinal nematodes in ostriches, Struthio camelus, in different regions of the state of Rio de Janeiro, Brazil / Nematoides gastrintestinais em avestruzes, Struthio camelus, de diferentes regiões do Estado do Rio de Janeiro, Brasil

The ratite group is composed of ostriches, rheas, emus, cassowaries and kiwis. Little research has been done on parasitism in these birds. The aim of this study was to determine the distribution of infections by gastrointestinal nematodes in ostriches in the state of Rio de Janeiro. For this, fecal samples were collected from 192 on 13 farms. From each sample, four grams of feces were used to determine the eggs per gram of feces (EPG) count, by means of the McMaster technique. Part of the feces sample was used for fecal cultures, to identify 100 larvae per sample. The results were subjected to descriptive central trend and dispersion analysis, using confidence intervals at the 5% error probability level in accordance with the Student t distribution, and Tukeys test with a 95% confidence interval. The mean EPG in the state was 1,557, and the municipality of Três Rios had the lowest average (62). The city of Campos dos Goytacazes presented the highest mean EPG of all the municipalities analyzed. The northern region presented the highest mean EPG, followed by the southern, metropolitan, coastal lowland and central regions. Libyostrongylus species were observed on all the farms: L. douglassii predominated, followed by L. dentatus and Codiostomum struthionis. .(AU)

O grupo das ratitas é composto pelas avestruzes, emas, emús, cassuares e kiwi. São poucas as pesquisas sobre as parasitoses nessas aves. O objetivo deste estudo foi determinar a distribuição de infecções por nematóides gastrintestinais em avestruzes no Estado do Rio de Janeiro. Para tanto, foram coletadas amostras fecais de 192 avestruzes de 13 propriedades. De cada amostra, quatro gramas foram utilizados para a contagem de ovos por grama de fezes (OPG), pela da técnica de McMaster. Parte das fezes foi utilizada para cultivos fecais para identificação de 100 larvas por amostra. Os resultados foram submetidos à análise descritiva de tendência central e de dispersão, utilizando-se o intervalo de confiança ao nível de 5% de probabilidade de erro de acordo com a distribuição t de Student e teste de Tukey com intervalo de confiança de 95%. A média de OPG no Estado foi de 1.557, e o município de Três Rios obteve a menor média (62). A cidade de Campos dos Goytacazes teve a maior média de OPG de todos os municípios analisados. A Região Norte teve a maior média de OPG, seguida das regiões Sul, Metropolitana, Baixada Litorânea e Central. As espécies de Libyostrongylus foram observadas em todas as propriedades, predominando L. douglassii, seguido de L. dentatus e Codiostomum struthionis.(AU)

Association among H. pylori virulence markers dupA, cagA and vacA in Brazilian patients

Only a few Helicobacter pylori-infected individuals develop severe gastric diseases and virulence factors of H. pylori appear to be involved in such clinical outcomes. Duodenal ulcer promoting gene A (dupA) is a novel virulence factor of Helicobacter pylori that is associated with duodenal ulcer development and reduced risk for gastric carcinoma in some populations. The aims of the present study were to determine the presence of dupA gene and evaluate the association among dupA and other virulence factors including cagA and vacA in Brazilian patients. Gastric biopsies were obtained from 205 dyspeptic patients (100 children and 105 adults). DNA was extracted and analyzed for the presence of H. pylori and its virulence factors using the polymerase chain reaction method.(AU)

Association among H. pylori virulence markers dupA, cagA and vacA in Brazilian patients

Only a few Helicobacter pylori-infected individuals develop severe gastric diseases and virulence factors of H. pylori appear to be involved in such clinical outcomes. Duodenal ulcer promoting gene A (dupA) is a novel virulence factor of Helicobacter pylori that is associated with duodenal ulcer development and reduced risk for gastric carcinoma in some populations. The aims of the present study were to determine the presence of dupA gene and evaluate the association among dupA and other virulence factors including cagA and vacA in Brazilian patients. Gastric biopsies were obtained from 205 dyspeptic patients (100 children and 105 adults). DNA was extracted and analyzed for the presence of H. pylori and its virulence factors using the polymerase chain reaction method.

Perfuração gástrica em um canino induzida por nimesulida / Gastric perforation in a canine induced by nimesulide

Os anti-inflamatórios não esteroides (AINEs) têm sido muito utilizados na clínica de pequenos animais (FOX e JOHNSTON, 1997). Esses medicamentos possuem excelentes efeitos terapêuticos no alívio da dor e no tratamento de processos inflamatórios, no entanto possuem efeitos adversos especialmente no trato gastrointestinal onde podem promover o aparecimento de úlceras focais. As úlceras são lesões caracterizadas pela destruição da mucosa do trato gastroentérico (WILLARD, 2003). O objetivo deste trabalho é relatar o tratamento cirúrgico de um canino diagnosticado com úlcera gástrica perfurante devido ao uso de nimesulida.

Perfuração gástrica em um canino induzida por nimesulida / Gastric perforation in a canine induced by nimesulide

Os anti-inflamatórios não esteroides (AINEs) têm sido muito utilizados na clínica de pequenos animais (FOX e JOHNSTON, 1997). Esses medicamentos possuem excelentes efeitos terapêuticos no alívio da dor e no tratamento de processos inflamatórios, no entanto possuem efeitos adversos especialmente no trato gastrointestinal onde podem promover o aparecimento de úlceras focais. As úlceras são lesões caracterizadas pela destruição da mucosa do trato gastroentérico (WILLARD, 2003). O objetivo deste trabalho é relatar o tratamento cirúrgico de um canino diagnosticado com úlcera gástrica perfurante devido ao uso de nimesulida.(AU)

Perfuração de úlcera gastroduodenal em felino – relato de caso / Gastroduodenal perfuration ulcer in a cat – case report

As úlceras gastroduodenais são incomuns em gatos e suas causas ainda não estão bem esclarecidas (LIPTAK et al., 2002; CARIOU et al., 2010). Contudo, elas podem estar associadas a neoplasias, anti-inflamatórios não esteroidais, estresse, hiperacidez gástrica, hipovolemia, falência renal, endoparasitas e intoxicações (LIPTAK et al., 2002; NELSON e COUTO, 2006; CARIOU et al., 2010). O presente estudo tem como objetivo relatar um caso de úlcera gastroduodenal em felino.

Perfuração de úlcera gastroduodenal em felino relato de caso / Gastroduodenal perfuration ulcer in a cat case report

As úlceras gastroduodenais são incomuns em gatos e suas causas ainda não estão bem esclarecidas (LIPTAK et al., 2002; CARIOU et al., 2010). Contudo, elas podem estar associadas a neoplasias, anti-inflamatórios não esteroidais, estresse, hiperacidez gástrica, hipovolemia, falência renal, endoparasitas e intoxicações (LIPTAK et al., 2002; NELSON e COUTO, 2006; CARIOU et al., 2010). O presente estudo tem como objetivo relatar um caso de úlcera gastroduodenal em felino.(AU)

Gastroduodenal lesions in racehorses: evaluation and mapping according to the Updated Sidney System and Equine Gastric Ulcer Syndrome Council Classification

Gastroduodenal ulceration is found in 90% of Thoroughbred race horses. The clinical and economical importance of gastric ulcers and the scarce information about the subject in Brazil make this investigation essential. The aim of this study was to evaluate and map grossly and microscopically the gastroduodenal lesions in race horses according to the Updated Sidney System and the Equine Gastric Ulcer Syndrome Council (EGUSC) Classification. Necropsy was performed in 14 horses and macroscopy was described. Samples of the gastric regions (14 animals - nonglandular fundus, glandular fundus, margo plicatus, antrum and pylorus) and duodenum (9 animals) were obtained and processed for routine histopathology. Macroscopic evaluation of the lesions based on the Updated Sidney System showed that 100% of the horses had gastric ulcers or erosions, mainly located at the margo plicatus. The Updated Sidney System also allowed a macroscopic gastritis classification and revealed that seven horses had enanthematous gastritis (50%), four had hemorrhagic gastritis (28, 6%), and three had erosive gastritis (21, 4%). Based on the EGUSC Classification, the most frequent score is 2 (50%). The score 3 was found in 35,7% of the horses and the scores 1 and 4 in 7,1% each. The score 0 which means intact epithelium, was not seen in any of the horses. Histopathological evaluation based on the Updated Sidney System revealed mild to severe lymphoplasmacytic infiltrate, sometimes with areas of neutrophilic infiltrate, demonstrating some activity mainly in the injured mucosa. Lymphoid follicles were found in 92.9% of the animals. This study confirms that gastric ulceration in Brazilian race horses is common, and the majority consists of chronic ulceration of the margo plicatus. The use of the histopathological division of the Updated Sidney System demonstrated that chronic gastritis was predominant and the majority of cells in the inflammatory infiltrate were lymphocytes and plasmocytes. This study also showed that the association of the Updated Sidney System and the EGUSC Classification is feasible and leads to a better understanding of equine gastroduodenal ulceration. Although usually neglected, these lesions may be involved in low performance rates and therefore other investigations are necessary for the elucidation of the etiology and pathogenesis of these ulcers.(AU)

Contribuição do exame radiográfico contrastado no diagnóstico de úlcera duodenal não perfurada em cadela de grande porte - relato de caso / Contribution of radiographic contrast examination to the diagnosis ofunperforated duodenal ulcer in a large bitch - case report / Contribución del examen radiográfico contrastado para el diagnóstico deuna úlcera duodenal no perforada en una perra grande - relato de caso

As úlceras duodenais são menos frequentes que as gástricas e causas comuns de vômito crônico sem diarreia em cães. O diagnóstico e mais comumente dado por meio dos sinais clínicos e de exames complementares como a endoscopia e a laparotomia exploratória, quando há suspeita de perfuração, e, por vezes, exames ultrassonográficos, radiográficos e tomográficos. O exame radiográfico passou a ter um valor secundário a partir do momento em que outras técnicas, principalmente a endoscopia, passaram a fazer parte do rol de exames complementares em medicina veterinária. No entanto, este relato de caso de uma cadela com sinais clínicos evidentes de úlcera no trato digestivo mostra a importância do exame radiográfico em situações em que outros métodos tiveram resultado negativo ou não estavam disponíveis, sendo uma alternativa segura e eficaz para o diagnóstico de úlceras duodenais não perfuradas.

Duodenal ulcers are less common than gastric ulcers and are common causes of chronic vomiting without diarrhea in dogs. The diagnosis is most commonly achieved by means of clinical signs and complementary tests such as endoscopy and laparotomy, when there is suspicion of perforation, and sometimes ultrasound, radiography and CT scans. Radiographic examination has become secondary since other techniques, especially endoscopy, became part of the complementary exams used in veterinary medicine. Despite that, this article highlights the importance of the radiographic examination when other methods are negative or unavailable, by reporting the case of a dog with evident clinical signs of ulcer in the digestive tract. Radiography is still a safe and effective alternative for the diagnosis of non-perforated duodenal ulcers.

En los perros, las úlceras duodenales son menos frecuentes que las gástricas, y ambas provocan vómitos crónicos sin presencia de diarrea. EI diagnóstico se consigue con mayor frecuencia a través de los signos clinicos y de ciertos exámenes complementarios como la endoscopia y la laparotomía exploratoria, en aquellos casos donde se sospecha de una perforación, siendo también utilizados los exámenes ecográficos, radiográficos y la tomografía computarizada. La radiografia pasó a tener una importancia menor a partir de que otras técnicas, principalmente la endoscopia, pasaron a formar parte de los exámenes complementarios en medicina veterinaria. No obstante, el caso que se relata en el presente trabajo, de una perra con signos clínicos evidentes de úlcera en el sistema digestivo, muestra la importancia de la radiografía en situaciones en que no se obtuvieron resultados positivos con otras técnicas, o que no estaban disponibles, siendo una alternativa segura y eficiente para el diagnóstico de las úlceras duodenales no perforadas.

Contribuição do exame radiográfico contrastado no diagnóstico de úlcera duodenal não perfurada em cadela de grande porte - relato de caso / Contribution of radiographic contrast examination to the diagnosis ofunperforated duodenal ulcer in a large bitch - case report / Contribución del examen radiográfico contrastado para el diagnóstico deuna úlcera duodenal no perforada en una perra grande - relato de caso

As úlceras duodenais são menos frequentes que as gástricas e causas comuns de vômito crônico sem diarreia em cães. O diagnóstico e mais comumente dado por meio dos sinais clínicos e de exames complementares como a endoscopia e a laparotomia exploratória, quando há suspeita de perfuração, e, por vezes, exames ultrassonográficos, radiográficos e tomográficos. O exame radiográfico passou a ter um valor secundário a partir do momento em que outras técnicas, principalmente a endoscopia, passaram a fazer parte do rol de exames complementares em medicina veterinária. No entanto, este relato de caso de uma cadela com sinais clínicos evidentes de úlcera no trato digestivo mostra a importância do exame radiográfico em situações em que outros métodos tiveram resultado negativo ou não estavam disponíveis, sendo uma alternativa segura e eficaz para o diagnóstico de úlceras duodenais não perfuradas.(AU)

Duodenal ulcers are less common than gastric ulcers and are common causes of chronic vomiting without diarrhea in dogs. The diagnosis is most commonly achieved by means of clinical signs and complementary tests such as endoscopy and laparotomy, when there is suspicion of perforation, and sometimes ultrasound, radiography and CT scans. Radiographic examination has become secondary since other techniques, especially endoscopy, became part of the complementary exams used in veterinary medicine. Despite that, this article highlights the importance of the radiographic examination when other methods are negative or unavailable, by reporting the case of a dog with evident clinical signs of ulcer in the digestive tract. Radiography is still a safe and effective alternative for the diagnosis of non-perforated duodenal ulcers.(AU)

En los perros, las úlceras duodenales son menos frecuentes que las gástricas, y ambas provocan vómitos crónicos sin presencia de diarrea. EI diagnóstico se consigue con mayor frecuencia a través de los signos clinicos y de ciertos exámenes complementarios como la endoscopia y la laparotomía exploratoria, en aquellos casos donde se sospecha de una perforación, siendo también utilizados los exámenes ecográficos, radiográficos y la tomografía computarizada. La radiografia pasó a tener una importancia menor a partir de que otras técnicas, principalmente la endoscopia, pasaron a formar parte de los exámenes complementarios en medicina veterinaria. No obstante, el caso que se relata en el presente trabajo, de una perra con signos clínicos evidentes de úlcera en el sistema digestivo, muestra la importancia de la radiografía en situaciones en que no se obtuvieron resultados positivos con otras técnicas, o que no estaban disponibles, siendo una alternativa segura y eficiente para el diagnóstico de las úlceras duodenales no perforadas.(AU)

ABO blood groups and Helicobacter pylori cagA infection: evidence of an association

Diseases resulting from Helicobacter pylori infection appear to be dependent on a host of genetic traits and virulence factors possessed by this microorganism. This paper aimed to investigate the association between the ABO histo-blood groups and H. pylori cagA infections. Genomic DNA samples (n = 110) of gastric biopsies obtained from patients with endoscopic diagnosis of peptic ulcers (n = 25) and chronic active gastritis (n = 85) were analyzed by PCR using specific primers for the cagA gene. Of the samples, 66.4 percent (n = 73) tested positive and 33.6 percent (n = 37) negative for the gene. The cagA strain was predominant in peptic ulcers (n = 21; 84.0 percent) compared with chronic active gastritis (n = 52; 61.2 percent) (p = 0.05; OR 3.332; 95 percent CI: 1.050-10.576). Additionally, the cagA strain was prevalent in the type O blood (48/63; 76.2 percent) compared with other ABO phenotypes (25/47; 53.2 percent) (p = 0.01; OR 2.816; 95 percent CI: 1.246-6.364). These results suggest that H. pylori cagA infection is associated with the O blood group in Brazilian patients suffering from chronic active gastritis and peptic ulcers.(AU)

FREQUÊNCIA E INTENSIDADE DE LESÕES GASTRODUODENAIS EM CÃES COM MASTOCITOMA CUTÂNEO

A síndrome paraneoplásica é definida como um conjunto de sinais e sintomas que acontecem distantes do tumor primário e de suas metástases. Nos mastocitomas, os sinais sistêmicos mais comuns são os sinais gastrintestinais secundários à liberação de histamina, heparina e outras substâncias bioativas contidas no interior dos mastócitos neoplásicos. Em decorrência da ação sistêmica destas substâncias, a ulceração gastrintestinal é a principal síndrome paraneoplásica descrita. Assim, o presente trabalho avalia a ocorrência de lesões gastroduodenais em cães com mastocitoma cutâneo no momento do diagnóstico, correlacionando seu aparecimento com a apresentação clínica da doença, aparência macroscópica do tumor, diferentes marcadores prognósticos pré-estabelecidos pela literatura e valores plasmáticos de histamina. Para tal, foram utilizados 41 cães da rotina clinico/oncológica do Hospital de Clínicas Veterinárias da Universidade Federal do Rio Grande do Sul (HCV-UFRGS) com diagnóstico confirmado de mastocitoma cutâneo. Os animais foram avaliados clinicamente e, posteriormente, foram submetidos à cirurgia para exérese do tumor e exame endoscópico para avaliação do esôfago, estômago e porção proximal do duodeno. Todos os cães foram avaliados quanto a presença e a gravidade dos sinais clínicos, velocidade de crescimento tumoral, número e localização dos nódulos, tamanho tumoral, características macroscópicas do tumor, presença de metástase em linfonodo regional, classificação histopatológica, índice mitótico e valor de histamina plasmática, buscando-se estabelecer uma relação com o surgimento e a gravidade das lesões gástricas e duodenais. A análise macro e microscópica da mucosa gástrica e duodenal, não evidenciou lesões compatíveis com úlceração grave em nenhum dos cães avaliados. A ocorrência de sinais clínicos gastrintestinais foi observada em 41,5% dos casos e padrões inflamatórios, sugestivos de gastrite, foram evidenciados tanto no exame endoscópico quanto no exame histopatológico. Sendo assim, na população estudada, as lesões gastroduodenais observadas foram consideradas leves no momento do diagnóstico e não apresentaram relação estatística com as variáveis estudadas, sugerindo que a heterogenicidade da população possa ter contribuído para os resultados, ou ainda que outros fatores possam influenciar a degranulação dos mastócitos neoplásicos.

Paraneoplastic syndrome is defined as a set of signs and symptoms that are not related to the local effect of the primary tumor or its metastases. Gastrointestinal ulceration is the most common sign attributed to mast cell tumors paraneoplastic syndrome in dogs. In mastocytoma, release of histamine, heparin, and other bioactive substances by the neoplastic mast cells can lead to increased systemic action of these substances and induce gastrointestinal disturbances. This study aimed to evaluate the occurrence of gastroduodenal lesions in dogs with cutaneous mast cell tumor at the time of diagnosis and correlate them to the clinical presentation of the disease, tumors macroscopic aspects, neoplasic prognostic markers, and plasmatic histamine values. We evaluated 41 dogs with cutaneous mast cell tumor diagnosed at the oncology service of the Veterinary Hospital of the Federal University of Rio Grande do Sul (UFRGS-HCV). After clinical examination, as the animals underwent surgery to remove the tumor and endoscopy to evaluate the esophagus, stomach and proximal duodenum was performed Presence and severity of clinical signs, neoplasms macroscopic characteristics, tumor size, number and location of neoplasic masses, tumor growth rate, presence of regional lymph node metastasis, histopathological classification, mitotic index, and plasmatic histamine concentration were determined and correlated with gastrodueodenal endoscopic findings. The macro and microscopic analyses of the gastric and duodenal mucosa showed no lesions compatible with ulceration in any of the pacients. The occurrence of gastrointestinal clinical signs was observed in 41.5% of cases and inflammatory patterns, suggestive of gastritis were evidenced in both endoscopic and histopathological examination; however, its correlation with the presence of mast cell tumor could not be established. Therefore, in this population, gastroduodenal lesions observed were considered mild at diagnosis and had no relation with the variables analyzed, suggesting that the heterogeneity of the population may have contributed to the results or that other factors may influence the degranulation of mast cells neoplastic.

Estenose de piloro em eqüino adulto / Pyloric stenosis in a mature horse

Neste trabalho, é descrito um caso de estenose hipertrófica de piloro diagnosticado por gastroscopia em um eqüino Quarto de Milha, de quatro anos de idade, que apresentava inapetência, emagrecimento progressivo, cólica, bruxismo e sialorréia. A gastroduodenite ulcerativa crônica e os espasmos prolongados foram as supostas causas da hipertrofia da musculatura circular do piloro, causando a estenose. O tratamento com substâncias antiulcerativas é paliativo e o acesso cirúrgico ao piloro no animal adulto é complexo, sendo o prognóstico duvidoso.(AU)

A case of hypertrophic pyloric stenosis diagnosed by gastroscopy was reported in a 4-years-old Quarter Horse gelding, with signs of inappetence, chronic weight loss, colic, bruxism and sialorrhea. Gastroduodenal ulceration and spasms were supposed as causes of pyloric muscular hypertrophy and stenosis. Antiulcerative medications are merely palliative and the complex surgical approach to the site of stenosis makes the prognostic to be doubtful.(AU)

Perforated duodenal ulcer associated with nonsteroidal anti-inflammatory drug administration in a dairy cow

A case report of perforated duodenal ulcer in a 4.5 year-old Holstein cow is presented. The cow was treated with an overdose of diclofenac sodium. Necropsy findings included diffuse fibrinous peritonitis and microscopically there was severe necrosis and acute inflammation of the duodenum at the margin of the ulcer. Although gastrointestinal ulcers are often associated with non-steroidal anti-inflammatory drugs in others species, it is rarely described in cattle.

Perforated duodenal ulcer associated with nonsteroidal antiinflammatory drug administration in a dairy cow

A case report of perforated duodenal ulcer in a 4.5 year-old Holstein cow is presented. The cow was treated with an overdose of diclofenac sodium. Necropsy findings included diffuse fibrinous peritonitis and microscopically there was severe necrosis and acute inflammation of the duodenum at the margin of the ulcer. Although gastrointestinal ulcers are often associated with non-steroidal anti-inflammatory drugs in others species, it is rarely described in cattle.

Duodenoplastia associada à vagotomia gástrica proximal no tratamento das úlceras duodenais estenosantes

Proximal gastric vagotomy has been accepted as the procedure of choice for the elective surgical treatment of chronic duodenal ulcers, being the safest operation when considering morbidity and mortality. Its application has been extended to duodenal to complicated ulcer means of a complementary operation aiming to solve the complication. With the aim of evaluating the proximal gastric vagotomy in the treatment of stenosing duodenal ulcers the clinical results of 80 consecutive patients treated with proximal gastric vagotomy plus vagotomy (VGP + Dp) were compared to those of a series of 106 patients submitted to selective gastric vagotomy plus antrectomy (VGS + A). These patients were evaluated for a period of 2 to 16 years after surgery. The series were homogeneous related in gender and age. Five different types of duodenoplast were performed, according to anatomic characteristics of the stenosed duodenum. In the VGS + A group the reconstruction of alimentary tract was gastroduodenal in 46 patients and gastrojejunal in 60 patients. Post operative endoscopic control showed patency of the duodenal lumen and preserved pyloric sphincter in the patients submitted to duodenoplaty. Ulcer recurrence ocurred in 5% after VGP + Dp and in 1,9% after VGS + A. Late postoperative complications such as diarrhea dumping and bilious vomiting were more frequent and more severe among the patients treated with VGS + A. Bilious vomiting did not occur and dumping and diarrhea were rare, mild and transitory after VGP + Dp. The overall clinical assessment, according to Visick classification, showed excelent results in 73% of the patients with VGP + Dp and in 42% of the patients with VGS + A; excelent and good result were found in 87% of the patients of the first group and in 76% of the second group. The better performance of proximal gastric vagotomy, with less frequent side effects and milder and transitory late complications, turns 5% to 10% ulcer recurrence tolerable and makes it acceptable as the operation of choice for the treatment of uncomplicated chronic duodenal ulcer.

A vagotomia gástrica proximal firmou-se como o procedimento de escolha no tratamento cirúrgico eletivo das úlceras duodenais crônicas, por ser a operação mais segura quanto à morbidade e mortalidade. Sua aplicação tem sido estendida às complicações da úlcera duodenal, mediante operação complementar que visa solucionar a complicação. Com o objetivo de avaliar a vagotomia gástrica proximal no tratamento das úlceras duodenais estenosantes os resultados clínicos de uma série consecutiva de 80 pacientes submetidos à vagotomia gástrica proximal e duodenoplastia (VGP + Dp) foram comparativos aos de uma série de 106 pacientes submetidos à vagotomia gástrica seletiva e antrectomia (VGS + A); os pacientes foram avaliados 2 a 16 anos após a cirurgia. As séries foram homogêneas quanto ao sexo e à idade. Cinco diferentes tipos de duodenoplastia foram realizados, de acordo com as características anatômicas do duodeno estenosado No grupo da VGS + A a reconstrução do trânsito alimentar foi gastroduodenal em 46 pacientes e gastrojejunal nos 60 pacientes restantes. O índice de mortalidade operatória foi de 1,2% com VGP + Dp e de 1,9% com VGS + A. Controle endoscópico pós-operatório demonstrou patência da luz duodenal e piloro conservado nos pacientes submetidos à duodenoplastia. A recorrência ulcerosa ocorreu em 5% após VGP + Dp e em 1,9% após VGS + A. Conclui-se que: 1. a duodenoplastia resolve a estenose duodenal sem dano do esfíncter pilórico, mantendo as vantagens da vagotomia gástrica proximal sem operação complementar de drenagem do estômago. 2 Na avaliação clínica global os melhores resultados foram obtidos com a vagotomia gástrica proximal. 3. A vagotomia gástrica proximal associada à duodenoplastia é uma boa opção de tratamento da úlcera duodenal estenosante.

DUODENOPLASTIA ASSOCIADA À VAGOTOMIA GÁSTRICA PROXIMAL NO TRATAMENTO DAS ÚLCERAS DUODENAIS ESTENOSANTES

Proximal gastric vagotomy has been accepted as the procedure of choice for the elective surgical treatment of chronic duodenal ulcers, being the safest operation when considering morbidity and mortality. Its application has been extended to duodenal to complicated ulcer means of a complementary operation aiming to solve the complication. With the aim of evaluating the proximal gastric vagotomy in the treatment of stenosing duodenal ulcers the clinical results of 80 consecutive patients treated with proximal gastric vagotomy plus vagotomy (VGP + Dp) were compared to those of a series of 106 patients submitted to selective gastric vagotomy plus antrectomy (VGS + A). These patients were evaluated for a period of 2 to 16 years after surgery. The series were homogeneous related in gender and age. Five different types of duodenoplast were performed, according to anatomic characteristics of the stenosed duodenum. In the VGS + A group the reconstruction of alimentary tract was gastroduodenal in 46 patients and gastrojejunal in 60 patients. Post operative endoscopic control showed patency of the duodenal lumen and preserved pyloric sphincter in the patients submitted to duodenoplaty. Ulcer recurrence ocurred in 5% after VGP + Dp and in 1,9% after VGS + A. Late postoperative complications such as diarrhea dumping and bilious vomiting were more frequent and more severe among the patients treated with VGS + A. Bilious vomiting did not occur and dumping and diarrhea were rare, mild and transitory after VGP + Dp. The overall clinical assessment, according to Visick classification, showed excelent results in 73% of the patients with VGP + Dp and in 42% of the patients with VGS + A; excelent and good result were found in 87% of the patients of the first group and in 76% of the second group. The better performance of proximal gastric vagotomy, with less frequent side effects and milder and transitory late complications, turns 5% to 10% ulcer recurrence tolerable and makes it acceptable as the operation of choice for the treatment of uncomplicated chronic duodenal ulcer.

A vagotomia gástrica proximal firmou-se como o procedimento de escolha no tratamento cirúrgico eletivo das úlceras duodenais crônicas, por ser a operação mais segura quanto à morbidade e mortalidade. Sua aplicação tem sido estendida às complicações da úlcera duodenal, mediante operação complementar que visa solucionar a complicação. Com o objetivo de avaliar a vagotomia gástrica proximal no tratamento das úlceras duodenais estenosantes os resultados clínicos de uma série consecutiva de 80 pacientes submetidos à vagotomia gástrica proximal e duodenoplastia (VGP + Dp) foram comparativos aos de uma série de 106 pacientes submetidos à vagotomia gástrica seletiva e antrectomia (VGS + A); os pacientes foram avaliados 2 a 16 anos após a cirurgia. As séries foram homogêneas quanto ao sexo e à idade. Cinco diferentes tipos de duodenoplastia foram realizados, de acordo com as características anatômicas do duodeno estenosado No grupo da VGS + A a reconstrução do trânsito alimentar foi gastroduodenal em 46 pacientes e gastrojejunal nos 60 pacientes restantes. O índice de mortalidade operatória foi de 1,2% com VGP + Dp e de 1,9% com VGS + A. Controle endoscópico pós-operatório demonstrou patência da luz duodenal e piloro conservado nos pacientes submetidos à duodenoplastia. A recorrência ulcerosa ocorreu em 5% após VGP + Dp e em 1,9% após VGS + A. Conclui-se que: 1. a duodenoplastia resolve a estenose duodenal sem dano do esfíncter pilórico, mantendo as vantagens da vagotomia gástrica proximal sem operação complementar de drenagem do estômago. 2 Na avaliação clínica global os melhores resultados foram obtidos com a vagotomia gástrica proximal. 3. A vagotomia gástrica proximal associada à duodenoplastia é uma boa opção de tratamento da úlcera duodenal estenosante.