Anoplasty and rectovaginal fistula repair in a gilt with atresia ani: A case report.

A 2-year-old female Vietnamese potbellied pig was referred to the Large Animal Teaching Hospital at the Ontario Veterinary College for anoplasty and rectovaginal fistula repair. The presence of atresia ani and rectovaginal fistula had been previously diagnosed. Contrast radiography was used to confirm the diagnosis and determine the position of the fistula and terminal rectum. Under general anesthesia, the urethra was catheterized. An incision was made at the anatomic location of the anus, the rectovaginal fistula was isolated through deep dissection, and a Penrose drain was placed around it for caudal retraction. Transvaginal catheter placement through the fistula and into the rectum assisted with anatomic location. Once the urogenital and gastrointestinal tracts were clearly identified, the fistula was transected as close to the vaginal cavity as possible. The vaginal defect was sutured, and the fistula tract was mobilized 90° and sutured to the skin, creating the anal canal. Postoperative complications included constipation and cystitis. The gilt passed feces 5 d after surgery and was discharged on Day 11 of hospitalization. Normal urination and defecation were observed at the time, and fecal incontinence was resolved. Six months after surgical intervention, the gilt remained continent and no complications were reported. Key clinical message: Anoplasty and rectovaginal fistula repair were completed successfully in a gilt. Preservation of the fistula and its use during anal reconstruction may provide an internal anal sphincter and may be associated with improved continence.

Anoplastie et réparation de la fistule recto-vaginale chez une cochette avec atrésie anale : rapport de cas. Une femelle cochon vietnamien de 2 ans a été référée au Large Animal Teaching Hospital du Ontario Veterinary College pour une anoplastie et réparation d'une fistule recto-vaginale. La présence d'une atrésie anale et d'une fistule recto-vaginale avait déjà été diagnostiquée. Une radiographie de contraste a été utilisée pour confirmer le diagnostic et déterminer la position de la fistule et du rectum terminal. Sous anesthésie générale, l'urètre a été cathétérisé. Une incision a été faite à l'emplacement anatomique de l'anus, la fistule recto-vaginale a été isolée par dissection profonde et un drain de Penrose a été placé autour d'elle pour la rétraction caudale. Le placement d'un cathéter transvaginal à travers la fistule et dans le rectum a aidé avec la localisation anatomique. Une fois les voies urogénitale et gastro-intestinale clairement identifiées, la fistule a été sectionnée aussi près que possible de la cavité vaginale. Le défaut vaginal a été suturé et le trajet de la fistule a été mobilisé à 90° et suturé à la peau, créant le canal anal. Les complications postopératoires incluaient la constipation et la cystite. La cochette a expulsé des matières fécales 5 jours après la chirurgie et a obtenu son congé le 11e jour d'hospitalisation. Une miction et une défécation normales ont été observées à ce moment-là, et l'incontinence fécale a été résolue. Six mois après l'intervention chirurgicale, la cochette présentait encore de la continence urinaire et aucune complication n'a été signalée.Message clinique clé :L'anoplastie et la réparation de la fistule recto-vaginale ont été réalisées avec succès chez une cochette. La préservation de la fistule et son utilisation lors de la reconstruction anale peuvent fournir un sphincter anal interne et peuvent être associées à une meilleure continence.(Traduit par Dr Serge Messier).

Atresia anal com fístula retovaginal em ovino: relato de caso / Anal Atresia with rectovaginal fistula in sheep: case report

A atresia anal com fístula retovaginal, é considerada uma afecção congênita rara nos ovinos. Em virtude disso, buscou-se descrever o reparo cirúrgico e cuidados pós-operatórios em uma borrega que apresentava essa afecção. Nesse sentido, uma borrega, sem raça definida, de 25 dias de idade e pesando 7,2kg, apresentou sinais de distensão abdominal e defecação pela vulva. A afecção foi diagnosticada por meio do exame clínico e confirmada radiograficamente, constatando-se atresia anal do tipo III em associação com a fístula.(AU)

Atresia ani associated with rectovaginal fistula is considered a rare congenital anomaly in sheep. Therefore, the surgical correction and post-operative care of a lamb presenting atresia ani with rectovaginal fistula has been detailed in this case report. A 25-days old, mixed breed lamb, weighing 7.2 kg, showing signs of abdominal bloating, and stool passage through the vulva was admitted at our hospital. An atresia ani type III condition associated with rectovaginal fistula was diagnosed by clinical examination and confirmed by radiographic examination.(AU)

Congenital multiple arthrogryposis in bovine / Artrogripose congênita múltipla em bovino

This report describes an anal atresia, anatomical urethra alteration (slightly caudal to the udder), thickened joints, and changes in the pelvis in a newborn Holstein cow. Visualization of the final portion of the rectum was not possible by perineal access and laparotomy through the right flank was performed in order for abdominal exploration and colostomy attempt. During the surgical procedure visceral rupture and malformations incompatible with life were observed, so surgeons opted for euthanasia and necropsy. Alterations were confirmed in the genitourinary and gastrointestinal tract. The non-formation of the anus caused dilation of the distal portion of the rectum with fecal content retention, which was drained to the body of the uterus, with the presence of meconium. This amount of anatomical and clinical changes were diagnosed as congenital multiple arthrogryposis.(AU)

Este relato de caso descreve atresia anal, alteração anatômica da uretra (inserida caudalmente ao úbere), articulações espessadas e alterações na pelve em um neonato bovino da raça Holandesa. A visualização da porção final do reto não foi possível pelo acesso perineal, e laparotomia através do flanco direito foi feita para exploração abdominal e realização da colostomia. Durante o procedimento cirúrgico, foram observadas ruptura visceral e malformações incompatíveis com a vida, então os cirurgiões optaram pela eutanásia e necropsia. Alterações foram confirmadas nos tratos geniturinário e gastrointestinal. A não formação do ânus causou dilatação da porção distal do reto com retenção fecal, desviando ao corpo do útero, o qual possibilitou a entrada de mecônio nesse compartimento, além de outras alterações devido à ingestão e alteração no trânsito gastrointestinal. Essa quantidade de alterações anatômicas e clínicas foi diagnosticada como artrogripose congênita múltipla.(AU)

Partial urorectal septum malformation sequence in a kitten with disorder of sexual development.

A 2-month-old kitten exhibited simultaneously an imperforate anus, hypospadias, rectourethral fistula and genital dysgenesis (penis restricted to the glans, absence of prepuce and bifid scrotum). Surgical correction consisted of separation of the urinary and digestive tracts, perineal urethrostomy and connection of the rectum to the newly made anal opening. Pathological examination of the testes, conventionally removed at 9 months of age, showed no mature spermatozoa and underdevelopment of germ and Leydig cells. In humans, the absence of an anal opening in association with abnormal sexual development defines the urorectal septum malformation sequence. Here, we describe the first case of this syndrome in a kitten with a normal male karyotype (38,XY) and a normal coding sequence for the SRY gene. Both the rectourethral fistula and observed genital abnormalities might have been induced by a disturbance in the hedgehog signalling pathway. However, although four polymorphic sites were identified by DHH gene sequencing, none cosegregated with the malformation.

Perineal choristoma and atresia ani in 2 female Holstein Friesian calves.

Atresia ani, a congenital anomaly of the anus, can be associated with other types of malformation. Two female Holstein Friesian calves had imperforate anus, rectovaginal fistula, and perineal choristomas. In one case, the choristoma was composed of mature adipose and fibrous tissue with nephrogenic rests. In the other calf, the choristoma consisted of fragments of trabecular bone coated by cartilage and containing marrow, mixed with mature adipose and fibrous tissue, striated muscle fibers, nerves, and vessels. This combination of malformations resembles the association of anorectal malformations and perineal masses in children.

Long-term results of surgery for atresia ani with or without anogenital malformations in puppies and a kitten: 12 cases (1983-2010).

OBJECTIVE: To evaluate signalment, clinical findings, surgical treatment, and long-term outcomes in puppies and kittens after surgical repair of various types of atresia ani (AA) with or without concomitant anogenital or rectogenital malformations. DESIGN: Retrospective case series. ANIMALS: 11 puppies and 1 kitten. PROCEDURES: Medical records of 2 veterinary teaching hospitals were reviewed for puppies and kittens that underwent surgical treatment for AA. Information regarding signalment, diagnosis, surgical procedures, follow-up time, and outcome was recorded. A previously described classification scheme was used to classify AA as type I, II, III, or IV. Follow-up times and outcomes were evaluated. RESULTS: AA was classified as type I in 3 animals, type II in 6, and type III in 3. Nine of 12 patients had anogenital or rectogenital malformations; 8 of these had rectovaginal fistulas. Eleven animals underwent in situ anoplasty, and 1 underwent surgery in which the rectovaginal fistula was used for anal reconstruction. Six also underwent balloon dilation for treatment of anal stenosis, and revision anoplasty was performed in 5. All patients with type I or II AA survived ≥ 1 year. Two puppies with type III AA were euthanized 3 and 40 days after surgery. Follow-up time for the remaining 10 patients ranged from 12 to 92 months, and 3 had fecal incontinence. CONCLUSIONS AND CLINICAL RELEVANCE: Surgical repair of type I or II AA resulted in long-term survival and fecal continence in most cases. Although numbers were small, patients with type III AA had poorer outcomes than did those with type I or II AA.

Creation of a urethral conduit from a preputial indirect flap in a dog with perineal hypospadias.

OBJECTIVE: To report a surgical technique for creation of a urethral conduit using a preputial indirect flap. STUDY DESIGN: Case report. ANIMALS: Male Doberman Pinscher (6 weeks old). METHODS: A urethral conduit was constructed using a multistage preputial indirect flap in a dog with severe perineal hypospadias. RESULTS: Successful transfer of a perineal located urethral meatus to a more anatomically normal inguinal location was achieved with a preputial flap. The procedure was performed to aid control of recurrent urinary tract infections after anal and urethral separation in a dog with imperforate anus, urethrorectal fistula, and proximal perineal hypospadias. CONCLUSIONS: Creation of a urethral conduit from a tubed bipedicle flap using redundant preputial tissue eliminated fecal contamination of the urethral meatus, aiding control of urinary tract infection. A good functional and cosmetic outcome was achieved. CLINICAL RELEVANCE: This technique should be considered in aiding control and prevention of urinary tract infections in dogs with proximal perineal hypospadias where a preputial remnant exists.

Surgical repair and management of congenital intestinal atresia in 68 calves.

OBJECTIVE: To determine outcome and survival rate after surgical treatment of intestinal atresia, gender predilection, and effect of rectal palpation on the cause of atresia coli in calves. STUDY DESIGN; Prospective clinical study. ANIMALS: Newborn calves (n=68). METHODS: Data collected were husbandry system, anamneses, physical examination findings, surgical treatments, and postoperative results. Calves with atresia ani, and with atresia coli et recti had anal reconstruction and right flank colostomy, respectively. In midflank colostomized calves, the inner muscular layers were dissected to form a valve-like stoma. RESULTS: Of 68 calves with intestinal atresia, 37 were treated surgically. Anal reconstruction was performed in 21 calves with atresia ani with a long-term survival rate of at least 6 months with good condition. Colostomy was performed in 14 calves with atresia coli and 1 with atresia coli et recti; survival rate was 73%. The case morbidity rate for intestinal atresia was 13.8% and for atresia coli, 5.7% in the hospital population. No gender predilection for occurrence of atresia ani and atresia coli was identified. Palpation per rectum for early pregnancy diagnosis did not predispose to atresia coli. CONCLUSION: Surgical treatment of atresia ani through circular anal skin removal has a good prognosis for survival. Colostomy is not an acceptable treatment from the calf's perspective because of the resulting poor condition but the high survival rate is important to allow continued milk production of the dam. CLINICAL RELEVANCE: Early diagnosis, supportive treatment, and surgical correction are important in management of atresia coli.

Use of a temporary incontinent end-on colostomy in a cat for the management of rectocutaneous fistulas associated with atresia ani.

A 2 1/2-month-old cat was evaluated for the presence of multiple draining tracts ventral to the tail of 8 days duration. Clinical and radiographic examination revealed that the cat had rectocutaneous fistulas and type II atresia ani. The cat underwent a temporary end-on colostomy for faecal diversion. Sixty days after surgery and after the fistulas resolved the animal underwent a second surgery for colostomy closure and anal reconstruction. Two years after surgery the cat was reported to be in good health with no faecal incontinence.

Management of neonatal llamas and alpacas.

Most llama and alpaca crias will be born without complication and survive the neonatal period without incident. However, it is important to be able to recognize which crias are likely to be at risk of complications so that you are best able to advise owners and take the correct course of action if required. This article deals with management of the pregnant camelid, the events associated with parturition and the peripartum period with emphasis on the cria, management of the newborn cria including assessment of passive transfer of immunity, issues relating to prematurity, and the major congenital defects that may present as emergencies within the neonatal period.

Successful surgical correction of anal atresia in a transgenic cloned piglet.

Inbred strains of pig become indispensable for a wide range of biological studies. In biomedical science, it is generally accepted that somatic cell nuclear transfer (SCNT) technology with inbreed strain of pig is essential for xenotransplantation. In this study, we observed the anal atresia in a cloned pig which was derived from fetal fibroblast of inbreed miniature pig. A presumptive anal site of the cloned pig was excised and the rectum was sutured to apposed skin for treatment. This cloned piglet seemed to be normal with healthy status after surgery. This report can be useful for the treatment of anal atresia of cloned piglets.

Preservation of the fistula for reconstruction of the anal canal and the anus in atresia ani and rectovestibular fistula in 2 dogs.

OBJECTIVE: To report a technique for correction of atresia ani and rectovestibular fistula with fistula preservation, and outcome in 2 dogs. STUDY DESIGN: Case report. ANIMALS: Two intact female puppies. METHODS: The fistula was approached by episiotomy. A vertical median perineal incision was made starting dorsal to the anal region and extended to surround the fistula. The rectum and vagina were separated, and the end of the fistula was sutured to the skin. RESULTS: Early postoperative complications included constipation, fecal incontinence, and perineal soiling, but long-term outcome was good in both dogs. CONCLUSION: With careful dissection, the fistula and internal anal sphincter can be preserved and used in the surgical reconstruction of the anal canal and anus. CLINICAL RELEVANCE: Preservation of the fistula may provide an internal sphincter that contributes to a better functional result during correction of atresia ani. A surgical approach that combines episiotomy and perineal incision for separation of the vagina and rectum, and preserves the fistula may decrease the risk of dehiscence.

Atresia ani with diphallus and separate scrota in a calf: a case report.

Atresia ani, a common genetic defect in animals, is often accompanied by urogenital defects in calves. This paper reports a case of atresia ani with diphallus and separate scrota in a calf. The calf was born with atresia ani; surgery (to open the anus) was performed 3 days after birth. No urogenital abnormalities were noticed until 4 months after birth. At that time, two separate scrota (each containing a testis) and a sac-like structure in the middle of two scrota, were visible. The gait was abnormal, with abduction of the hind limbs while walking. Additionally, the hind legs appeared wider than usual at the hip joints. Two weeks later, two peni (diphallia) was observed, each in a separate preputial sheath. The calf had a normal karyotype on cytogenetic examination. Plasma concentrations of testosterone at 5.5, 6, and 7 months of age were 3.5, 1.9, and 1.7 ng/ml, respectively. At necropsy (7 months of age), the prepuce was thick and the glans of the right penis was adhered to the prepuce. The left penis did not have a urethra or retractor penis muscles. The sac-like structure in the middle of the two scrota contained the urinary bladder and a loop of small intestine. The pubic bone had failed to fuse at the pelvic symphysis. In conclusion, this is the first reported case of atresia ani with diphallus, separate scrota, and pubic bone separation in a calf.

[Morphologic studies in swine with anal atresia]. / Morphologische Untersuchungen bei Ferkeln mit Analatresien.

33 piglets with anorectal malformations were investigated histologically. 24 animals were male, 9 female. 18 piglets had high deformities with recto-urethral, respectively recto-vaginal fistulas. 15 animals had low deformities. In all animals we were able to demonstrate a sphincter internus muscle and a sphincter externus muscle. The sphincter internus muscle was localised around the fistula. These fistulas also had other characteristics of a normal anal opening.