Small bowel intramural hematoma caused by warfarin: case report and literature review.

BACKGROUND: Intramural hematoma of the small bowel is a rare yet acute gastrointestinal condition typically linked with impaired coagulation function, often posing diagnostic challenges. It is principally encountered in patients undergoing prolonged anticoagulant therapy, specifically warfarin. CASE PRESENTATION: We reported a case of intramural hematoma associated with warfarin use. The patient was admitted to hospital with abdominal pain and had received anticoagulant therapy with warfarin 2.5 mg/day for 4 years. Laboratory examination showed decreased coagulation function, abdominal CT showed obvious thickening and swelling of part of the jejunal wall, and abdominal puncture found no gastroenteric fluid or purulent fluid. We treated the patient with vitamin K and fresh frozen plasma. The patient was discharged after the recovery of coagulation function. Then we undertaook a comprehensive review of relevant case reports to extract shared clinical features and effective therapeutic strategies. CONCLUSION: Our analysis highlights that hematoma in the small intestinal wall caused by warfarin overdose often presents as sudden and intense abdominal pain, laboratory tests suggest reduced coagulation capacity, and imaging often shows thickening of the intestinal wall. Intravenous vitamin K and plasma supplementation are effective non-surgical strategies. Nevertheless, in instances of severe obstruction and unresponsive hemostasis, surgical resection of necrotic intestinal segments may be necessary. In the cases we reported, we avoided surgery by closely monitoring the coagulation function. Therefore, we suggest that identifying and correcting the impaired coagulation status of patient is essential for timely and appropriate treatment.

Rectal Perforation Secondary to a Self-Administered Water-Hose Enema: A Case Report and Literature Review.

Chronic functional constipation is a common condition that can have a significant impact on a patient's quality of life and healthcare costs. Hydrostatic enemas are a commonly observed practice among patients with chronic constipation. Rectal perforation is a rare yet serious complication that can be fatal if not diagnosed and treated promptly. Here, we present the case of an elderly lady with Parkinson's disease who presented with upper rectal perforation after using a hydrostatic enema and was treated with Hartmann's procedure. This case highlights the importance of having a low threshold for suspecting and diagnosing colorectal perforation in patients presenting with abdominal pain after receiving a hydrostatic enema.

Diagnosis and Treatment Reasoning of Integrated Traditional Chinese and Western Medicine Against Acute Abdomen Based on Knowledge Graph / 中国实验方剂学杂志

ObjectiveIn view of the standardization of clinical diagnosis and treatment of the acute abdomen and the inheritance of diagnosis and treatment experience of prestigious veteran traditional Chinese medicine（TCM） doctors， a diagnosis and treatment reasoning algorithm based on association rule mining under incomplete evidence（AMIE）+ random walk was proposed to provide information services and technical support for primary doctors by recommending personalized diagnosis and treatment plans based on medical records. MethodThe experience of diagnosis and treatment of acute abdomen of prestigious veteran TCM doctors and the text data of clinical diagnosis and treatment guidelines of integrated TCM and western medicine were collected to complete the task of knowledge extraction and construct acute abdomen knowledge graph based on Neo4j. On the basis of ontology-supported rule-based reasoning， the rule reasoning based on similar syndromes was used to expand the syndrome combinations whose Jaccard similarity was greater than the threshold in the syndrome recommendation results. The semantic path coverage algorithm was used to calculate the semantic similarity between the symptom nodes. The symptom nodes were divided into 10 categories， and the symptom nodes in the same category were extended. The random walk algorithm was used to search the symptom nodes connected with the syndrome， and the connection rules between the syndrome and symptom nodes were extended to realize the knowledge reasoning of AMIE+ random walk. ResultThe acute abdomen knowledge graph included 1 320 nodes and 2 464 relationships. According to the link prediction evaluation index of knowledge reasoning， the reasoning results of the three algorithms in the auxiliary diagnosis and treatment of acute abdomen were compared. The AMIE+ random walk algorithm complemented the knowledge graph by extending the similar syndrome connection rules and the syndrome-symptom connection rules. Compared with the knowledge reasoning algorithm based on ontology rules， the area under the curve （AUC） was 15.18% higher and the accuracy was 30.36% higher， which achieved more accurate and effective knowledge inference. ConclusionThis study used knowledge graph technology to visualize the diagnosis and treatment of acute abdomen with TCM and western medicine， assisting primary clinicians in intuitively viewing the diagnosis and treatment process and data relationship. The proposed diagnosis and treatment reasoning algorithm can realize the personalized diagnosis and treatment plan recommendation at the level of "disease-syndrome-diagnosis-treatment-prescription"， which can assist primary doctors in disease diagnosis and treatment and clinical decision-making， contribute to the knowledge sharing and application of diagnosis and treatment experience and clinical guidelines of prestigious veteran TCM doctors， improve the level of primary clinical diagnosis and treatment， and promote the normalization and standardization of the diagnosis and treatment process of acute abdomen with integrated TCM and western medicine.

Broadening the List of Differential Diagnosis for Acute Abdomen - a Case Report from Nepal.

When a patient has an acute abdominal pain, it is important to identify if the underlying cause is life threatening. To that end, a thorough medical history and relevant investigation will be pivotal. Here we report a case of lead toxicity where the patient presented with an acute abdomen following intake of Ayurvedic medicines. The baseline blood lead level was 82.3 µg/dl. The Ayurvedic medicines when analyzed for its lead content, revealed high lead concentration. We observed that the cessation of Ayurvedic medication along with D-penicillamine therapy was beneficial in reducing the blood lead level and in alleviating abdominal pain. Our findings implicate the need of awareness program regarding the potential health hazards associated with the use Ayurvedic medicines.

Colonic torsion in 4 Great Danes.

OBJECTIVE: To describe 4 Great Danes with colonic torsions and describe the risk of torsion recurrence in this breed, which has not previously been reported. This study also describes pneumocolon as a rapid and noninvasive diagnostic for confirmation of colonic torsion. SERIES SUMMARY: Four Great Danes were presented with nonspecific gastrointestinal (GI) clinical signs. Colonic torsion was diagnosed in each case with either plain radiography identifying pneumocolon or contrast radiography (barium enema). Bloodwork in each case revealed nonspecific changes. Each case had a previous gastropexy, 3 of which were prophylactic and 1 as a surgical emergency for gastric dilatation-volvulus. Three cases had favorable outcomes with emergency surgical intervention and returned to normal activity levels with resolution of clinical signs. Two cases of colonic torsion recurred, 1 of which occurred subsequent to a prior left-sided colopexy. One case of recurrence had persistent clinical signs following surgical revision and was euthanized. NEW OR UNIQUE INFORMATION PROVIDED: This is the first report describing pneumocolon to identify a colonic torsion, providing a rapid and low-morbidity diagnostic aid and to describe the recurrence of colonic torsion in 2 dogs. Support to a previous hypothesis for an association between colonic torsion and altered GI motility is provided. Prior publications reporting colonic torsion and entrapment in German Shepherd Dogs associated with disruption of the duodenocolic ligament reported no recurrence following correction without colopexy. The recurrence in these 2 dogs suggests colonic torsion in Great Danes may represent a different or more severe form of this condition.

Latrodectism in Italy: First report of successful treatment of L. tredecimguttatus envenomation using L. mactans antivenom from North America.

INTRODUCTION: Latrodectism is a rare, but potentially severe, clinical syndrome caused by spider of the genus Latrodectus. L. tredecimguttatus is widespread in Italy and its bite cause the injection of α-latrotoxin that cause depletion of acetylcholine at motor nerve endings and release of catecholamines at adrenergic nerve endings. We describe the first clinical case of L. tredecimguttatus poisoning successfully treated with L. mactans antivenom from North America. CASE REPORT: A healthy 60-year-old patient was admitted to the emergency department after unknown insect sting or arachnid/snake bite. In the early morning, the patient was working in the countryside when he felt a sting-like pain in the medial area of the right lower leg, associated with an intense burning sensation. An hour later he developed agitation, hoarseness, sweating, abdominal distress and intense pain in his right leg. In the emergency room vital signs showed a hypertensive crisis, tachycardia and peripheral oxygen desaturation. ECG was normal and ABE showed mixed acid-base disorder. Blood tests showed leukocytosis with neutrophilia, high levels of myoglobin, with normal coagulation and normal plasmatic cholinesterase. Neck, thorax and abdomen CT scan, with and without contrast medium, was negative. Four hours after admission hypertension worsened with board like rigid abdomen and onset of fasciculations, tremors, miosis and intense regional sweating. The definitive diagnosis of poisoning by L tredecimguttatus was based on the clinical picture. Within short time the antidote was provided by the Poison Centre and administered. A marked improvement of the symptomatology was noted after 30 minutes, and 1 hour later all symptoms were under control. The patient was discharged after 2 days. CONCLUSIONS: The clinical presentation of a patient suffering from latrodectism places the clinician in front of a challenging differential diagnosis. Following the suspicion, the first-line doctor is invited to discuss the case with a toxicologist, in order to confirm or exclude the diagnosis and implement all therapeutic measures. In our clinical case, the absence of organic lesions, laboratory tests not suggestive for other causes, and the presence of typical clinical feature suggested the diagnosis of L tredecimguttatus poisoning. This hypothesis was then supported by the close temporal relation between antivenom administration and symptoms improvement. With this case, we report the first use of L mactans antivenom from North America to treat L.tredecimguttatus poisoning and we confirm its effectiveness in counteracting latrodectism caused by this spider.

Microbial findings, sensitivity and outcome in patients with postoperative peritonitis a retrospective cohort study.

BACKGROUND: Acute postoperative peritonitis resulting from previous abdominal surgery is still a severe and potentially fatal disease, which is associated with high morbidity and mortality. The aim of the present study was to evaluate patients' outcome after postoperative peritonitis and identify the most effective empiric antibiotic regimes. METHODS: 422 patients with acute postoperative peritonitis as a result to earlier abdominal operation (e.g. anastomotic leakage) were analyzed retrospectively focusing on the origin of the peritonitis, microbial flora and resistance patterns. Furthermore, mortality was estimated according to sensitivity results of the tested antibiotics. RESULTS: In 50% of the patients, anastomotic leakage was located in the colon. The predominantly cultured microorganisms were Escherichia coli and Enterobacteriaceae. The combination of meropenem and vancomycin was effective in 96% of these microbes. The frequently used combinations of piperacillin/sulbactam and cefotaxime/metronidazole were effective in only 67% and 43%, respectively. CONCLUSIONS: We were able to show that the currently used antibiotic regimes with piperacillin/sulbactam and cefotaxime/metronidazole are ineffective in a relevant number of patients with anastomotic leakage. Only meropenem or meropenem/vancomycin cover most of the microbes predominant in postoperative peritonitis.

[Small bowel perforation caused by intestinal dissemination of pulmonary tuberculosis due to biological therapy]. / Biológiai terápiát követoen fellángoló pulmonalis tbc enterális disszeminációja által okozott vékonybél-perforatio.

Case review: The authors present a case of a 78-year-old female patient who previously, as a teenager, had been treated for pulmonary tuberculosis. The biological therapy for subsequent inflammatory bowel disease in 2015 caused a flare up of the respiratory symptoms after 60 years of being asymptomatic, and the patient also developed acute abdomen. She required emergency laparotomy and small intestine segment resection was performed due to perforated ileum. Histological examination of the specimen showed intestinal tuberculosis as the cause of perforation. Following pharmacological therapy in the postoperative period the patient eventually became asymptomatic. Discussion: Tuberculosis is a life threatening disease which can virtually affect any organ system. The primary site of tuberculosis is usually the lung, from which it can get disseminated into other parts of the body. With this article we would like to raise the awareness of the potentially lethal side effects of biological and immune modulated therapies and we would also like to emphasize the importance of the cooperation of practitioners in different medical fields.

Acute Abdomen with Periumbilical Erythema.

A 33-year-old man with a history of a Malone Antegrade Continence Enema Procedure presented to the Emergency Department with right lower abdominal pain. Computed Tomography (CT) of the abdomen revealed an appendicitis of the appendicostomy with an associated appendicolith.

Validación de la puntuación de apendicitis pediátrica (pas) frente a la escala de alvarado, para el diagnóstico de apendicitis en niños de 4 a 15 años de edad / Validation of pediatric appendicitis score (SBP) versus the Alvarado scale, for the diagnosis of appendicitis in children 4 to 15 years of age

ANTECEDENTES: La apendicitis es la patología quirúrgi-ca más común en la infancia. Es necesario un método ágil y preciso para evitar el exceso de exámenes para-clínicos, errores diagnósticos y apendicectomías inne-cesarias. Las puntuaciones sistemáticas son los mejores procesos para ordenar manifestaciones clínicas y llegar al diagnóstico. ObjETIVO: Validar simultáneamente las puntuaciones PAS y Alvarado para el diagnóstico de apendicitis agu-da en niños de 4 a 15 años de edad, con abdomen agudo en urgencias pediátricas de un hospital de ter-cer nivel del sistema nacional de salud. MATERIALES y MéTODO: Se incluyeron 161 pacientes de 4 a 15 años de edad atendidos en el servicio de emer-gencia pediátrica del Hospital Vicente Corral Moscoso, con sospecha clínica de apendicitis aguda a los que se aplicó las dos puntuaciones antes de ser operados. El diagnóstico se confirmó con histología. Se comparó la capacidad diagnóstica de PAS y Alvarado y la propor-ción de acuerdos entre las pruebas con respecto del gold estándar.RESULTADOS: La muestra tuvo un predominio de varo-nes. Mediana de edad 12 años, peso 37.5 ± 12.2 kg, es-tatura 138.5 ± 15.4 cm y un 42% de malnutridos entre los que hubo: emaciación, sobrepeso y obesidad. La sen-sibilidad de PAS fue más alta (97.1 vs 79.8) aunque con especificidad más baja (50 vs 59). El valor predictivo negativo de PAS fue superior (73.1 vs 31.7). Los acuer-dos entre histología y pruebas en estudio fueron supe-riores para PAS (90.7% vs 74.5%). El 99% de apendicitis flegmonosa perteneció a PAS y el 84% a Alvarado. Se produjeron más falsos negativos con la puntuación de Alvarado (P< 0.001). CONCLUSIÓN: La puntuación PAS es una herramienta diagnóstica de uso fácil y confiable para decidir la ciru-gía de apendicitis aguda sospechada en niños. Hasta que se disponga de evidencia concluyente, el uso de ambas puntuaciones debe ser considerado como una buena práctica clínica.

bACkGROUND: The appendicitis is the most common surgical pathology in childhood. It is necessary an agi-le and accurate method to avoid excessive paraclini-cal examinations, diagnostic errors and unnecessary appendectomies. The systematic scores are the best processes for ordering clinical manifestations and reach the diagnosis.ObjECTIVE: To validate simultaneously the pediatric appendicitis score (PAS) and Alvarado scales for the diagnosis of acute appendicitis in children aged from 4 to 15 years old with acute abdomen in pediatric emer-gencies of a third level hospital in the national health system. MATERIALS AND METhODS: A total of 161 patients aged from 4 to 15 years old were treated at the Vicente Co-rral Moscoso Hospital in the pediatric emergency ser-vice with clinical suspicion of acute appendicitis. They were applied the two scores before the surgery. The diagnosis was confirmed with histology. We compared the diagnostic capacity of PAS and Alvarado, and the proportion of agreement between tests with respect to the gold standard. RESULTS: The sample had a predominance of males. The median age was 12 years, weight 37.5 ± 12.2 kg, height 138.5 ± 15.4 cm and 42% of malnutrition among those that were: emaciation, overweight and obesity. The sensitivity of PAS was higher (97.1 vs 79.8) although with lower specificity (50 vs 59). The negative predictive value of PAS was higher (73.1 vs 31.7). The agreements between histology and tests were higher for PAS (90.7% vs 74.5%). The 99% of phlegmonous appendicitis belon-ged to PAS and the 84% to Alvarado. More false negati-ves were produced with the Alvarado score (P <0.001). CONCLUSION: The PAS score is a reliable and easy diagnostic tool to use for deciding on acute appendi-citis surgery suspected in children. Until the conclusive evidence is available, the use of both scores should be considered as a good clinical practice.

Pregnancy outcomes after emergent laparoscopic surgery for acute adnexal disorders at less than 10 weeks of gestation.

AIM: To report our experience with pregnancy outcomes after emergent laparoscopic surgery for acute adnexal disorders at less than 10 weeks of gestation when surgical intervention could be more invasive to intrauterine pregnancy. METHODS: Gasless multiport laparoscopic surgery or transumbilical laparoendoscopic single-site surgery was performed with securing of the surgical view by the abdominal wall-lift method. Intraoperative autologous blood salvage and donation was performed in cases associated with significant hemoperitoneum. RESULTS: Six cases of ovarian bleeding with ruptured corpus luteal cyst, three cases of adnexal torsion with corpus luteal cyst, and one case each of ruptured heterotopic ampullary pregnancy and heterotopic tubal stump isthmic pregnancy after salpingectomy were managed. For ruptured corpus luteal cyst, hemostasis was achieved by removal of hematoma followed by suturing. For adnexal torsion, detorsion with cyst aspiration was performed in two cases and detorsion alone was performed in one case. For ruptured heterotopic ampullary pregnancy, unilateral salpingectomy was performed. For ruptured heterotopic tubal stump isthmic pregnancy after salpingectomy, removal of the expelled villous tissue followed by hemostatic coagulation was performed. In five cases associated with massive hemoperitoneum, intraoperative autologous blood salvage and donation were performed to avoid homologous blood transfusion. After surgery, seven live births were achieved, while two cases of biochemical pregnancy loss and a case of complete miscarriage were noted. CONCLUSION: Although miscarriage could be a significant concern in the perioperative period, gasless laparoscopic surgery appeared to be feasible for management of acute adnexal disorders at less than 10 weeks of gestation.

Successful open abdomen treatment for multiple ischemic duodenal perforated ulcers in dermatomyositis.

INTRODUCTION: Dermatomyositis is an autoimmune disease characterized by proximal myopathy, cutaneous Gottron papules and heliotrope rash; intestinal involvement associated to acute vasculitis is less common but could be a life-threatening condition. METHODS: A 21-year-old woman, affected by dermatomyositis, presented to our attention with a three-day story of severe abdominal pain, no bowel movement and biliary vomit. She was diagnosed with acute abdomen. A CT scan with bowel contrast demonstrated the presence of a leakage from the retroperitoneal aspect of duodenum. The surgical and clinical management in the light of literature review is presented. RESULTS: Our first approach consisted in primary repair of the duodenal perforation with omentopexy. Post-operative course was complicated by hemorrhage. A reintervention showed a new perforation associated with multiple ischemic intestinal areas. We performed a gastroenteric anastomosis with functional exclusion of the damaged duodenum and positioning of drainages to create a biliary fistula. A nutritional enteric tube and an open abdomen vacuum-assisted closure system to monitor the fistula creation and to prevent abdominal contamination and collections were positioned. To reduce the amount of biliary leakage, a percutaneous transhepatic biliary drainage was placed, with progressive fistula flow disappearance in four months. CONCLUSIONS: In patients with dermatomyositis, when clinical findings and symptoms suggest abdominal vasculitis, it is very important to be aware of the risk of bowel and particularly duodenal perforations. Open abdomen treatment favors control of contamination by gastrointestinal contents, offers temporary abdominal closure, helps ICU care and delays definitive surgery.

Características diagnósticas de la apendicitis aguda en el Hospital Regional de Duitama, Colombia en el periodo de Enero-Marzo del 2010 / Diagnostic characteristics of acute appendicitis at the regional hospital of Duitama, Colombia during the period of January-March in year 2010

Introducción: la apendicitis aguda sigue siendo la enfermedad que con mayor frecuencia obliga a una intervención quirúrgica; la historia clínica y el examen físico son considerados como las herramientas más útiles en el diagnóstico. Objetivo: describir los signos y síntomas registrados en una serie de casos de apendicitis aguda, diagnosticados en el Hospital regional de Duitama, Boyacá, Colombia. Materiales y Métodos: se realizó un estudio observacional, analítico, de corte transversal. Se revisaron los registros clínicos de 99 casos de apendicitis operados en la institución durante el período Enero-Marzo de 2010. Los principales signos y síntomas se registraron según la frecuencia de presentación. Se establecieron las medias para variables continuas y los porcentajes para las discretas, con intervalos de confianza del 95%. Se realizó análisis estratificado por edad, género, tiempo de evolución y diagnóstico histopatológico. Resultados: el 56,6% de los casos se presentaron en varones (n=56) y el promedio de edad fue de 27,9 años (SD=16,4). Los síntomas

relevantes encontrados fueron: dolor abdominal (94,5%), migración del dolor (65,6%) y emesis (53,5%). Respecto a los hallazgos clínicos, fueron predominantes el signo de Blumberg positivo (59,4%), leucocitosis (74,7%) y neutrofilia (70,7%). La necrosis se encontró asociada con sintomatología mayor de 48 horas de evolución, leucocitosis superior a 15 000/mm3, y frecuencia cardíaca superior a 85 lat/min. Conclusión: existen síntomas y signos de alto valor para el diagnóstico correcto de la apendicitis: dolor abdominal, migración del dolor, signo de Blumberg, leucocitosis y neutrofi lia. Es recomendable que las instituciones educativas en el área de medicina fortalezcan el entrenamiento médico en los mecanismos y conocimientos adecuados para realizar oportunamente el diagnóstico, con miras a minimizar el riesgo de perforación. Esto es debido a que el diagnóstico temprano, depende de la facilidad de acceso a una atención especializada, a la vez que esta es eminentemente clínica...

Introduction: acute appendicitis remains as the most common disease that requires surgery. Medical record and physical examination are considered the most useful tools in diagnosis. Objective: to describe the main signs and symptoms registered in a list of cases diagnosed as acute appendicitis at the Hospital of Duitama, Boyacá, Colombia. Materials and Methods: analytical, observational, cross sectional study. It was reviewed the medical records of 99 cases of appendicitis operated at the Duitama Regional Hospital during the period from January to March 2010. The main signs and symptoms were recorded by frequency of presentation, means for continuous variables and percentages for the discrete ones, with their respective confidence intervals at 95%. There were carried out a stratified analysis by age, gender, type of diagnosis and histopathological diagnosis. Results: 56.6% were males, mean age 27.9 years (SD = 16.4); the most important symptoms found were abdominal pain (94.5%), migration of pain (65.6% ), vomiting

(53.5%); as predominant signs: Blumberg (59.4%), WBC> 12000 / mm3, and neutrophils >70 (70.7%); necrosis was associated with progression time greater than 48 hours, leukocytosis greater than 15 000 / mm3 and heart rate above 85 per minute. Conclusion: there are symptoms and signs of high value for the correct diagnosis of appendicitis: abdominal pain, migration of pain, rebound tenderness, leukocytosis and neutrophilia. It is recommended for training institutions, to establish mechanisms that emphasize medical training, for to obtain early diagnoses and to minimize the risk of perforation, because early diagnosis depends on the ease of access to specialist care and diagnosis is mainly clinical...

Perfil e distribuição da síndrome cólica em eqüinos em três unidades militares do Estado do Rio de Janeiro, Brasil / Profile and distribution of equine colic syndrome in three military units in Rio de Janeiro, Brazil

Este estudo teve como objetivo avaliar o perfil e a distribuição da síndrome cólica em equinos de três unidades militares no Estado do Rio de Janeiro, o Regimento Escola de Cavalaria (REsC), a Academia Militar das Agulhas Negras(AMAN) e o Esquadrão Escola de Cavalaria (EEC). No período entre 2003 e 2004, 770 equinos foram acompanhados para a ocorrência de casos clínicos de cólica. Realizou-se análise descritiva dos dados, e foram calculadas a taxa de incidência de cólica e a proporção de equinos acometidos. O teste do χ2 foi utilizado para avaliar a associação entre síndrome cólica evariáveis relativas às características dos equinos e do manejo. A incidência variou entre as unidades militares, 0,12 na AMAN, 0,21 no EEC e 0,95 casos/equino-ano no REsC, sendo acometidos 15% dos equinos da AMAN, 30% do EEC e 69% do REsC. A maior incidência foi de episódios de origem gástrica, 76,5%. Casos de reincidência foram elevados, sendo 62,5% no REsC, 36,7% na AMAN e 29,0% no EEC. A síndrome cólica estava significativamente associada às variáveis unidade militar, sistema de criação, quantidade de grãos ingerido esuplemento mineral-vitamínico. As altas incidências, reincidências e proporção de animais acometidos observadas ocorreram de forma diferenciada nas três unidades, indicando que, apesar de possuírem como característica comumpertencerem a unidades militares, os equinos formam um grupo heterogêneo no que diz respeito à ocorrência de síndrome cólica, provavelmente devido às diferentes condições de manejo.

This research aimed to verify the profile and distribution of colic syndrome in horses of three military units in Rio de Janeiro, Brazil, which were Regimento Escola de Cavalaria (REsC), Academia Militar das Agulhas Negras (AMAN), and Esquadrão Escola de Cavalaria (EEC). From 2003 to 2004, 770 horses were followed up for the incidence of colic cases. A descriptive analysis of clinical data, incidence of colic cases and rate of horses affected was established. Chisquared test was used to evaluate the association among colic syndrome and variables related to horses characteristics and management. Colic syndrome incidence varied among military units as follows: 0.12 cases/horse-year at AMAN, 0.21 at EECand 0.95 at REsC, affecting 15% of horses in AMAN, 30% in EEC and 69% in REsC. The highest incidence was of gastric episodes (76.5%). Recurrence cases were 62.5% in REsC, 36.7% in AMAN and 29.0% in EEC. Colic syndrome occurred associated with variables: military unit, management, amount of intake grains and supplemented mineral-vitamin. Highincidence, recurrence and horses rate with colic were differentiated among the three units. Although the horses of military units had common characteristic , they formed a heterogeneous group in respect to colic syndrome occurrence, probably due to different management conditions.

Effect of Prescription of Dredging Intestines to Dispel Heat for Enema on Postoperative Serum C-reactive Protein Content in Acute Abdomen Induced by Pyemia / 广州中医药大学学报

[Objective] To observe the effect of prescription of dredging intestines to dispel heat for enema on serum C-reactive protein content in acute abdomen (AA) induced by pyemia. [Methods] Fifty-seven cases of AA induced by py-emia were randomly allocated to two groups. On the basis of routine operation and application of antibiotics, Group A was treated with prescription of dredging intestines to dispel heat for enema and Group B with saline enema additionally. Therapeutic effect and C-reactive protein content in the two groups were observed and compared. [Results] All the cases in the two groups were cured. C-reactive protein content in Group A were decreased obviously in the 7th day after treatment (P