Left medial liver lobe torsion and postoperative acute gastric rupture in a 2.5-year-old male-castrated Flemish Giant rabbit (Oryctolagus cuniculus).

A 2.5-year-old male-castrated rabbit presented with acute abdominal pain, lethargy, and anorexia. Digital radiography revealed increased left-sided hepatomegaly, gastric dilation, and decreased peritoneal serosal detail. Abdominal ultrasonography identified a torsed left liver lobe, gastric dilation, and peritoneal effusion. Surgery confirmed a left medial liver lobe torsion, with subsequent lobectomy and seven days of hospitalization. The patient re-presented 2 days after discharge and suddenly died while hospitalized, with acute gastric rupture, fulminant peritonitis, and multifocal hepatic infarcts diagnosed on necropsy. We believe this is the first recorded imaging diagnosis of a left medial liver lobe torsion in a rabbit.

Catastrophic gastric rupture in a horse secondary to psyllium pharmacobezoars.

A mare was euthanized because of gastric rupture secondary to complete duodenal obstruction by 2 bezoars located in the pylorus and proximal duodenum. Infrared spectroscopy showed that the bezoars were composed of psyllium. The mare had been receiving treatment with a pelleted psyllium product at 4 times the recommended dosage. Veterinarians should be aware that treatment of colic in horses with pelleted psyllium products could be associated with gastric impaction.

Rupture gastrique catastrophique secondaire à des pharmacobézoards de psyllium en boulettes chez un cheval. Une jument a été euthanasiée en raison d'une rupture gastrique secondaire à une obstruction duodénale complète par deux bézoards situés dans le pylore et le duodénum proximal. La spectroscopie infrarouge a montré que les bézoards se composaient de psyllium. La jument avait reçu un traitement composé d'un produit de psyllium en boulettes à quatre fois la dose recommandée. Les vétérinaires devraient être au courant que le traitement des coliques chez les chevaux avec des produits de psyllium en boulettes pourrait être associé à une impaction gastrique.(Traduit par Isabelle Vallières).

Primary gastric rupture in 47 horses (1995-2011).

The purpose of this retrospective case-control study was to identify factors associated with primary gastric rupture and to investigate if there were differences between etiologies of primary gastric rupture. Compared to the general colic population, Quarter horses were under-represented and Friesians and draft breeds were over-represented in 47 cases of primary gastric ruptures. Horses with primary gastric rupture typically presented with severe clinical and clinicopathological derangements. There were 24 idiopathic gastric ruptures, 20 gastric impaction associated ruptures, and 3 perforating gastric ulcers. Thoroughbred horses were over-represented in the idiopathic gastric rupture group compared to other breeds and etiologies. This study suggests the presence of important breed predispositions for development of gastric rupture. Further study is necessary to identify if these predispositions are associated with management factors or breed-specific disorders.

Rupture gastrique primaire chez 497 chevaux (1995­2011). Le but de cette étude rétrospective de cas témoins était d'identifier les facteurs associés à la rupture gastrique primaire et de faire une enquête afin de déterminer s'il y avait des différences entre les étiologies de la rupture gastrique primaire. Comparativement à la population générale de coliques, les chevaux Quarter horse étaient sous-représentés et les Frisons et les races de trait étaient surreprésentées dans 47 cas de ruptures gastriques primaires. Les chevaux atteints de rupture gastrique primaire étaient présentés avec de graves dérangements cliniques et clinicopathologiques. Il y avait 24 ruptures gastriques idiopathiques, 20 ruptures associées à l'impaction gastrique et 3 perforations ulcéreuses gastriques. Les chevaux pur-sang étaient surreprésentés dans le groupe des ruptures gastriques idiopathiques comparativement à d'autres races et étiologies. Cette étude suggère la présence de prédispositions importantes des races pour le développement de la rupture gastrique. De nouvelles études sont nécessaires pour identifier si ces prédispositions sont associées aux facteurs de gestion ou à des troubles spécifiques aux races.(Traduit par Isabelle Vallières).

Clostridioides (Clostridium) difficile-associated disease, epiploic foramen entrapment, and gastric rupture in a Thoroughbred racehorse: case report and literature review.

Epiploic foramen entrapment (EFE) is a common cause of small intestinal colic in horses and may lead to intestinal strangulation. Strangulating intestinal obstruction impairs the gastrointestinal outflow and can lead to secondary gastric rupture and endotoxemia. Clostridioides difficile can cause enterotyphlocolitis with colic in horses of all ages, and the process is commonly referred to as C. difficile-associated disease (CDAD). Here we report the results of the postmortem examination of a 7-y-old Thoroughbred racehorse with concurrent CDAD, EFE, and gastric rupture that was euthanized following a history of colic over several days. A segment of distal jejunum and proximal ileum had passed through the epiploic foramen, and the intestinal wall was thickened and dark-red. The remaining small intestinal loops were distended and filled with blood-tinged contents. Peritonitis had resulted from escape of gastric contents into the abdominal cavity through a tear in the major curvature of the stomach. Histologically, the incarcerated segment had acute transmural hemorrhage with congestion and mucosal necrosis; neutrophilic infiltrates with fibrin thrombi were in the mucosa of the non-incarcerated small intestinal segments. C. difficile toxins were detected in the small intestinal contents, and C. difficile was isolated from the small intestine, colon, and cecum.

Primary gastric rupture in 20 horses from Midwestern Brazil: case report / Ruptura gástrica primária em 20 equinos no Centro-Oeste do Brasil: relato de caso

An 11-year (2007-2018) survey of epidemiological, clinical and pathological findings of horses with primary gastric rupture (PGR) was conducted. Twenty horses presented PGR, nine (45%) horses were clinically evaluated, eleven (55%) were sent dead, and all animals were necropsied. PGR contributed to a prevalence of 0.31% (9/2,868) of all equid attendances, 1.83% (9/491) of colic cases, and 4.1% (20/487) of all equid necropsies. Highly fermentable feed (n=7), gastric impaction (n=4), and perforating gastric ulcer (n=1) were the main causes of PGR; whilst eight horses presented idiopathic gastric rupture. Clinically evaluated horses were tachycardic, tachypneic, febrile, dehydrated, with increased abdominal tension, abnormal mucous membranes and reduced to absent intestinal borborygmi. Improper dietary management, such as the ingestion of low-quality roughage and highly fermentable feedstuffs were detected as the main factors associated with PGR in Midwestern Brazil. It is important to raise awareness in horse owners about proper feed management to minimize PGR.(AU)

Foi realizado um levantamento de 11 anos (2007-2018) dos achados epidemiológicos, clínicos e patológicos de equinos com ruptura gástrica primária (RGP). Vinte equinos apresentaram RGP, dos quais nove (45%) foram avaliados clinicamente e 11 (55%) foram enviados mortos, sendo todos os animais necropsiados. A RGP contribuiu com prevalência de 0,31% de todos os atendimentos de equídeos (9/2.868), 1,83% (9/491) dos casos de cólica, e 4,1% (20/487) das necropsias em equídeos. Alimentos altamente fermentáveis (n=7), compactação gástrica (n=4) e perfuração de úlcera gástrica (n=1) foram as principais causas de RGP, enquanto oito equinos tiveram ruptura gástrica idiopática. Os equinos avaliados clinicamente apresentaram-se taquicárdicos, taquipneicos, febris, desidratados, com mucosas anormais, aumento da tensão abdominal e motilidade intestinal reduzida. O manejo inadequado da dieta, como a ingestão de forragens de baixa qualidade e alimentos altamente fermentáveis, foi o principal fator de risco associado à RGP no Centro-Oeste do Brasil. É importante aumentar a conscientização dos proprietários de equinos sobre o manejo alimentar adequado para minimizar a RGP.(AU)

Diffuse Infiltrative Gastrointestinal Lipomatosis in a Guinea Pig (Cavia porcellus).

An intact adult male guinea pig (Cavia porcellus) went into cardiopulmonary arrest during a surgical procedure, and efforts at resuscitation were unsuccessful. Gross examination revealed a gastric rupture along the greater curvature of the stomach, which was associated with free blood and ingesta in the abdominal cavity, and a 2-cm nodular, partially circumferential, soft-to-firm mass within the pyloric region. Histologically, the pyloric mass was composed of sheets of infiltrative adipocytes expanding the muscular wall. Similar infiltrative sheets of adipocytes were present adjacent to the rupture site and within the small intestine, cecum, and colon. These findings are consistent with diffuse infiltrative lipomatosis, an exceedingly rare condition in human and veterinary species. This report is the first description of this rare disease in guinea pigs, and the concurrent involvement of both the stomach and intestines has not been reported in any veterinary species.

Gastric rupture in horses: a review of 54 cases.

The historical, clinical, laboratory, surgical and necropsy findings in 54 cases of gastric rupture in horses are described. Eleven per cent of the deaths of horses undergoing exploratory coeliotomy for colic during the period of the study were a result of gastric rupture. Comparison with all horses which had exploratory coeliotomies for colic over an eight year period did not show that horses with gastric rupture were different from these reference horses regarding age, breed or season. There were fewer stallions than expected in the gastric rupture group. Horses with histories of both acute and chronic (more than 36 h) colic were susceptible to gastric rupture. Primary and idiopathic causes of gastric dilation and rupture accounted for about one-third of the horses. All but one of these cases resulting from secondary causes fell into three aetiologically-related groups: obstructive, peritoneal and enteric, with approximately equal numbers of horses in each group. Most of the ruptures occurred along the greater curvature of the stomach. At least six horses ruptured their stomachs postoperatively in the presence of an indwelling nasogastric tube. The presence or absence of gastric reflux following nasogastric intubation was not a reliable indicator, on its own, of gastric dilation. Horses that later died from gastric rupture had markedly elevated heart rate, hypochloraemia, peritoneal exudative effusion (particularly with evidence of sepsis), pre- and/or postoperative gastric reflux and small or large intestinal disease. However, no distinctive feature of these horses was shown to place them at risk of gastric rupture.

Intestinal decompression: preliminary study in the horse.

A technique of nasoduodenal (N-D) intubation and intestinal decompression was developed and used in the horse to explore the prevention of gastric and intestinal distention after abdominal surgical operation. Three styles of tubes (2 single-lumen tubes and 1 double-lumen tube) were positioned in the duodenum of 12 mature horses (10 experimental and 2 clinical) during laparotomy (without enterotomy), and an iatrogenic occlusion at the small intestine was created and later released in the 10 experimental horses. The 2 clinical horses had an exploratory laparotomy to correct a natural obstruction of the small intestine. After each horse recovered from surgical manipulation, suction was used to keep fluids from accumulating in the cranial part of the gastrointestinal tract. In 5 of the 12 horses, the most simple N-D tube was positioned successfully and functioned properly. Three of the 5 horses which were fasted before surgical manipulation (to obtain an empty stomach) survived without postsurgical complications. Volume of reflux material was measured. Clinical data, such as periods of comfort during decompression without giving analgesics, were recorded. Necropsies were done on 10 of the 12 horses (9 experimental and 1 clinical). Although already tested in 2 clinical horses, use of the N-D tube remains experimental, and the N-D tube functioned only in horses which were fasted before surgical manipulation. Perfection of a safe and dependable means of emptying the equine stomach of its solid ingesta before gastrointestinal intubation is done, is the next step in affording greater clinical application of the N-D tube for gastrointestinal decompression.

Gastric rupture in horses: 50 cases (1979-1987).

A computer-based search was conducted of medical and necropsy records of horses admitted to the teaching hospital from Jan 1, 1979, to Dec 31, 1987, to obtain the records of all horses admitted to the hospital for colic and subsequently found to have gastric rupture. Fifty cases of gastric rupture were found. The records were reviewed to obtain data regarding peritoneal fluid analysis. Cell counts of these samples were often erroneous because debris and clumps of bacteria were counted when most WBC were lysed. A cross-sectional study of gastric rupture cases versus all other colic cases regarding season of admission revealed that there was no association between season and the occurrence of gastric rupture. There was also no increased risk associated with age, gender, breed, and the occurrence of gastric rupture. One hundred colic cases, matched with the gastric rupture cases by year of admission, were randomly selected via a table of random numbers. A questionnaire regarding age, breed, gender, use of the horse, housing, diet, water source, deworming schedule, and medical history was completed from the medical records and phone conversations with the horse owners. The results indicated that horses on a diet of grass hay or grass/alfalfa hay only or those that drank water from a bucket, stream, or pond were at increased risk for having gastric rupture. In contrast, horses fed grain had a reduced risk.

Spontaneous pneumoperitoneum in two cats.

Spontaneous pneumoperitoneum is an infrequently observed presentation in cats. This report details two cases of pneumoperitoneum in the cat. The first case was suspected to have been caused by a gastric perforation secondary to gastric lymphoma. The second case was caused by a perforated gastric ulcer in a cat that had been recently treated with corticosteroids and a non-steroidal anti-inflammatory drug.

Datura seed intoxication in two horses.

A sunflower-based feed supplement grossly contaminated with the seed of a Datura sp. resulted in severe signs of poisoning in 2 horses. One horse died peracutely of acute gastric dilatation and rupture following ingestion of the contaminated feed. The 2nd horse developed unresponsive paralytic ileus that led to euthanasia. Examination of the feed and gastrointestinal contents of both horses showed a high proportion of the characteristic Datura sp. seeds. The clinical signs and pathology in both cases were consistent with intoxication by the parasympatholytic alkaloid components of Datura sp.

[Idiopathic gastric rupture in a Friesian foal]. / Maagruptuur bij een Fries veulen.

Acute idiopathic gastric rupture resulted in sudden death of a 4.5-months-old healthy Friesian foal. No morphological lesions were present which could explain the preceding gastric impaction. In this case hypodypsia may have been (partially) responsible for the impaction as only a mechanical drinking apparatus, unsuitably for horses, was available.

Resistance to rupture of the equine stomach / Resistência à ruptura do estômago equino

Equine colic is an important and common cause of disease and death in horses. Gastric rupture has been extensively described in the literature, and is known to affect expressive numbers of horses. Gastric dilatation, which precedes rupture, may be observed when the animal consumes large amounts of recently harvested grass or drinks water too fast, though diagnosis criteria also include infestation with Gastherophilus and the presence of ileus and distal intestinal obstructions. The objective of the present study was to determine the resistance to rupture of the equine stomach to air (mm Hg) and water (L) injection. Forty stomachs of young horses (20 geldings and 20 mares) with no defined breed were analyzed. Total organ length (cm), weight (g), greater curved length (cm), lesser curved length (cm) and height (cm) were measured, with no statistical difference between males and females (p > .05). However, stomachs of horses were larger than those of mares and therefore presented higher volumetric capacity (p<0.05). No difference between males and females was observed in the pressure assay (93mmg Hg). Rupture occurred along the greater curvature (99%) and on the visceral (80%) and diaphragmatic (20%) surfaces, across all layers of the gastric wall. Although the equine stomach is relatively small, the organ is considerably resistant to rupture, whether by injection of air or liquid. Horses and mares exhibit similar resistance values, although the stomach of females has smaller volumetric capacity.(AU)

A cólica é um dos problemas mais comuns na clínica de equinos sendo responsável por grande número de mortes. A ruptura gástrica tem sido amplamente descrita na literatura e acomete número expressivo de animais. A dilatação gástrica, que antecede a ruptura, pode advir do consumo excessivo de capim recém-cortado, ingestão rápida de água, infestação por Gastherophilus, ocorrência de íleo paralítico e obstruções intestinais distais. A ruptura gástrica tem sido amplamente descrita na literatura e acomete um número expressivo de animais. Este estudo objetivou determinar a resistência à ruptura do estômago equino mediante a insuflação de ar atmosférico (mmHg) e do preenchimento com água (L). Foram utilizados 40 estômagos de equinos adultos jovens (20 machos castrados e 20 fêmeas) sem raça definida. Medidas relativas ao comprimento total do órgão (cm), peso do órgão (g), curvatura maior (cm), curvatura menor (cm) e altura (cm) foram aferidas e não diferiram entre machos e fêmeas (p>0,05). No entanto, os estômagos dos machos apresentaram medidas superiores as das fêmeas e por assim serem, comportaram um maior volume de água (p<0,05). No teste de resistência mediante insuflação de ar atmosférico não houve diferença entre machos e fêmeas (93mmHg). Os rompimentos ocorreram ao longo da curvatura maior (99%) nas faces visceral (80%) e diafragmática (20%) e abrangeram todas as camadas da parede gástrica. Apesar de ser um órgão relativamente pequeno, o estômago dos equinos apresenta considerável resistência à ruptura, seja por líquido ou por ar atmosférico. Machos e fêmeas possuem resistência gástrica semelhante, embora o estômago das fêmeas equinas comporte um menor volume.(AU)

Fatal ingestion of floating net debris by two sperm whales (Physeter macrocephalus).

In 2008 two male sperm whales (Physeter macrocephalus) stranded along the northern California coast with large amounts of fishing net scraps, rope, and other plastic debris in their stomachs. One animal had a ruptured stomach, the other was emaciated, and gastric impaction was suspected as the cause of both deaths. There were 134 different types of nets in these two animals, all made of floating material, varying in size from 10 cm(2) to about 16 m(2). The variability in size and age of the pieces suggests the material was ingested from the surface as debris rather than bitten off from active gear. These strandings demonstrate that ingestion of marine debris can be fatal to large whales, in addition to the well documented entanglements known to impact these species.