Hydronephrosis in a bitch with ovarian remnant syndrome - postsurgical complications

Background: Elective ovariohysterectomy (OH) is minimally invasive, but when performed incorrectly, it can lead to postsurgical complications, such as stump pyometra, ovarian remnant syndrome and foci of adhesion generated by tissue reactions to threads and materials used in vessel hemostasis. The formation of adhesions and successive surgeries predisposes patients to other diseases, such as ureteral obstruction and hydronephrosis. Thus, we reported a case of hydronephrosis in a bitch submitted to conventional OH, followed by ovariectomy (OV) due to ovarian remnant syndrome and consequent intraperitoneal adhesions caused by successive surgical interventions. Case: A 11-year-old mixed breed medium size bitch with a history of stump pyometra and ovarian remnant syndrome (SOR) was treated at the Veterinary Hospital-HV of UFPA after 2 previous surgeries. It had been spayed using conventional OH and underwent ovariectomy OV approximately 4 years ago, as it showed signs of estrus after the first surgery, characterizing SOR. On physical examination, its abdomen was distended especially in the left hemiabdomen, with no palpable pain. Ultrasonography showed a cavity in the topographic area of the left kidney, with anechoic content, thin walls, and defined contour. There were nonvascularized tubular structures, suggesting hydroureter and severe hydronephrosis. Exploratory celiotomy was performed, showing the intense presence of abdominal adhesions, followed by an incision in the abdominal midline from the xiphoid process in a caudal direction to the pubis, thereby showing the left kidney. After vesical drainage of 900 mL of renal filtrate, atrophy of the renal parenchyma and preservation of the renal capsule was considered, resulting in its complete resection, followed by the synthesis of the abdominal wall. In the postoperative period, the patient was properly monitored and obtained a satisfactory outcome manifested by a complete recovery. After vesical drainage of 900 mL of renal filtrate, atrophy of the renal parenchyma and preservation of the renal capsule only was considered, resulting in its complete resection, followed by the synthesis of the abdominal wall. In the postoperative period, the patient was properly monitored and obtained a satisfactory outcome manifested by a complete recovery. After vesical drainage of 900 mL of renal filtrate, renal parenchymal atrophy and preservation of the renal capsule only was adopted. Discussion: The choice of the conventional OH technique, followed by the failure to perform, favored the formation of adhesions only diagnosed late. Less invasive alternatives achieved less long-term damage. Excessive intracavitary manipulation and reaction to the nylon suture thread favored the development of these adhesions, and consequently, unilateral obstruction of the left ureter, hydroureter, hypertrophy, and destruction of the renal parenchyma, led the patient to undergo a third surgery, namely, unilateral nephrectomy. In this case, no changes were observed in serum levels, leaving only a subtle abdominal enlargement with hydronephrosis installed silently. There was no possibility of carrying out initial surgical planning, as the affected kidney, making unilateral nephrectomy necessary. Currently, the patient has normal renal function in the contralateral organ, with no clinical or laboratory changes because the affected kidney was not functional, making unilateral nephrectomy necessary. Currently, the patient has normal renal function with no clinical or laboratory changes because the affected kidney was not functional, making unilateral nephrectomy necessary. Currently, the patient has normal renal function in the contralateral organ, with no clinical or laboratory changes.

Experimental evaluation of intra-abdominal adhesions comparing two different intraperitoneal meshes and the effect of a natural anti-inflammatory product on their formation

Purpose: In laparoscopic incisional hernia repair, meshes with a tissue-separating barrier are positioned intraperitoneally. Despite this property, the close contact between mesh and viscera involves a risk of adhesion formation. Some natural products, such as red propolis (RP), could reduce these adhesions owing to their anti-inflammatory properties. This study aimed to compare two different intraperitoneal meshes with respect to their characteristics of adhesion formation, histological findings and evaluate the role of RP in the development of these adhesions. Methods: 40 Wistar rats received placement of two different meshes (Symbotex and Dynamesh IPOM) on peritoneum. The animals were divided into two groups: control group (mesh) and treatment group (mesh and RP). After 7 and 14 days, 20 animals of each group underwent midline laparotomy to determine the adhesions and histological characteristics. Results: Out of the 40 animals, there were two deaths in the test group and two in the control group. All animals in both groups developed adherence to the mesh. At postoperative day (POD) 7, two Symbotex meshes presented firm adhesions and at POD 14, two Dynamesh meshes had firm adhesions as well. The comparison between the meshes under the effect of RP in relation to the control group showed no statistical difference. Conclusions: Both meshes showed intraperitoneal adhesions in all evaluated samples with similar results on the characteristics of adhesions. RP showed no effect on the incidence or gradation of intraperitoneal adhesions with the mesh.(AU)

Polypropylene meshes coated with chitosan/polyethylene glycol for the reconstruction of the abdominal wall: an experimental study in rats / Telas de polipropileno revestidas com o filme de quitosana/polietilenoglicol para a reconstrução da parede abdominal: estudo experimental em ratos

The aim of this study was to characterize the tissue reactions triggered by the polypropylene mesh coated with chitosan and polyethylene glycol film, and if it's able to prevent the formation of peritoneal adhesions. Defects in the abdominal wall of rats were induced and polypropylene meshes coated with chitosan/polyethylene glycol (CPEG group, n= 12) and uncoated (PP control group, n= 12) were implanted. On the fourth and forty-fifth postoperative day the formation of adhesion and the tissue reaction to the biomaterial was evaluated through histological and histochemical analysis. The area (P= 0.01) and severity (P= 0.002) of the adhesion was significatively less in the CPEG group. On the fourth day the foreign body reaction was less intense in CPEG group (P= 0.018) and the production of collagen fibers was more intense in this group (P= 0.041). The tissue reactions caused by the biomaterials were similar on the 45th day, with the exception of the high organization of collagen fibers in the CPEG group. The CPEG meshes did not fully prevent the formation of adhesions, but minimized the severity of the process. The foreign body reaction promoted by polypropylene meshes coated with CPEG is less intense than that triggered by uncoated polypropylene meshes.(AU)

O objetivo deste estudo foi caracterizar as reações tissulares desencadeadas pela tela de polipropileno revestida com o filme de quitosana e polietilenoglicol e verificar se ela é capaz de prevenir a formação de aderências peritoneais. Um defeito na parede abdominal dos ratos foi realizado, e as telas de polipropileno revestidas com quitosana/polietilenoglicol (grupo CPEG, n= 12) e sem revestimento (grupo controle PP, n= 12) foram implantadas. No quarto e no 45º dia pós-operatório, avaliou-se a formação de aderências e a reação tecidual ao biomaterial por análise histológica e histoquímica. A área (P= 0,01) e a severidade (P= 0,002) da aderência peritoneal foram significativamente menores no grupo CPEG no 45º dia. No quarto dia, observou-se que a reação do corpo estranho foi menor no grupo CPEG (P= 0,018), e a produção de fibras de colágeno mais intensa (P= 0,041). As reações tissulares causadas pelos biomateriais implantados foram semelhantes no 45º dia, com exceção da melhor organização das fibras colágenas no grupo CPEG. As telas CPEG não impediram completamente a formação de aderências, porém minimizaram a gravidade do processo. A reação de corpo estranho promovida por telas de polipropileno revestidas com CPEG é menos intensa do que a desencadeada por telas de polipropileno não revestidas.(AU)

Polypropylene meshes coated with chitosan/polyethylene glycol for the reconstruction of the abdominal wall: an experimental study in rats / Telas de polipropileno revestidas com o filme de quitosana/polietilenoglicol para a reconstrução da parede abdominal: estudo experimental em ratos

The aim of this study was to characterize the tissue reactions triggered by the polypropylene mesh coated with chitosan and polyethylene glycol film, and if it's able to prevent the formation of peritoneal adhesions. Defects in the abdominal wall of rats were induced and polypropylene meshes coated with chitosan/polyethylene glycol (CPEG group, n= 12) and uncoated (PP control group, n= 12) were implanted. On the fourth and forty-fifth postoperative day the formation of adhesion and the tissue reaction to the biomaterial was evaluated through histological and histochemical analysis. The area (P= 0.01) and severity (P= 0.002) of the adhesion was significatively less in the CPEG group. On the fourth day the foreign body reaction was less intense in CPEG group (P= 0.018) and the production of collagen fibers was more intense in this group (P= 0.041). The tissue reactions caused by the biomaterials were similar on the 45th day, with the exception of the high organization of collagen fibers in the CPEG group. The CPEG meshes did not fully prevent the formation of adhesions, but minimized the severity of the process. The foreign body reaction promoted by polypropylene meshes coated with CPEG is less intense than that triggered by uncoated polypropylene meshes.(AU)

O objetivo deste estudo foi caracterizar as reações tissulares desencadeadas pela tela de polipropileno revestida com o filme de quitosana e polietilenoglicol e verificar se ela é capaz de prevenir a formação de aderências peritoneais. Um defeito na parede abdominal dos ratos foi realizado, e as telas de polipropileno revestidas com quitosana/polietilenoglicol (grupo CPEG, n= 12) e sem revestimento (grupo controle PP, n= 12) foram implantadas. No quarto e no 45º dia pós-operatório, avaliou-se a formação de aderências e a reação tecidual ao biomaterial por análise histológica e histoquímica. A área (P= 0,01) e a severidade (P= 0,002) da aderência peritoneal foram significativamente menores no grupo CPEG no 45º dia. No quarto dia, observou-se que a reação do corpo estranho foi menor no grupo CPEG (P= 0,018), e a produção de fibras de colágeno mais intensa (P= 0,041). As reações tissulares causadas pelos biomateriais implantados foram semelhantes no 45º dia, com exceção da melhor organização das fibras colágenas no grupo CPEG. As telas CPEG não impediram completamente a formação de aderências, porém minimizaram a gravidade do processo. A reação de corpo estranho promovida por telas de polipropileno revestidas com CPEG é menos intensa do que a desencadeada por telas de polipropileno não revestidas.(AU)

Comportamento da membrana biossintética de celulose como implante peritendíneo em potros / Behavior of cellulose biosynthetic membrane as a peritendinous implant in foals

Background: Tendon injuries are common in horses and are commonly associated with lameness and athletic career disruption.Adhesions formed between the tendons and the surrounding tissues compromise the sliding and movement of the structures,compromising their functionality. Therefore, the control of adhesion formation is critical to restore the structural integrity of thetendon, as well as its biomechanical function. The aim of this study was to evaluate the behavior of the biosynthetic cellulosemembrane implanted in foals with surgically induced tendinitis of the superficial digital flexor.Materials, Methods & Results: Six healthy foals were used, which underwent tendinitis induction in the superficial digital flexorof the right and left forelimbs. The lesions was induced by local ischemia by crushing the tendon with hemostatic forceps. Thebiosynthetic cellulose membrane was implanted only in the right forelimb, involving the superficial digital flexor tendon in theregion of the ischemia and the left forelimb was used as control. After surgery, both forelimb were immobilized with syntheticplaster cast for 15 days. Ultrasonography was performed in six foals immediately before (M0), at 15° (M1) at and 30° (M2) day,and three were evaluate at 45° (M3) and 60° (M4) day after surgery. Incisional biopsies were performed in three animals on the30° day and in three animals on the 60° day after surgery. Histopathological examination involved the analysis of tissue disorganization, presence and type of inflammatory infiltrate and neovascularization, according to the score of 0 to 3. Ultrasonographyallowed visualization of the membrane, which was characterized as a continuous hyperechoic line at the edges of the tendon at15 days (M1). In addition, at 30 and 45 days after surgery, interruption of the hyperechoic line and reduction of echogenicitywere observed, and no echogenic lines were observed at 60 days after surgery...(AU)

The effect of Allium sativum in experimental peritoneal adhesion model in rats

Purpose:To evaluate the effect of garlic on formation of postoperative adhesions in rats.Methods:Twenty-four Sprague dawley rats were divided into three groups. In Group 1 (sham), laparotomy was performed and stitched up. In Group 2 (control), after laparotomy was performed, punctate hemorrhage was induced by cecal abrasion in the cecum and 2 cc of saline was intraperitoneally administered to each rat. In Group 3 (experimental), after laparotomy was performed, punctate hemorrhage was induced by cecal abrasion in the cecum and each rat was intraperitoneally administered a sterile Allium sativum derivative. The rats in all groups were re-laparotomized on postoperative day 7; samples were obtained from the peritoneal tissue surrounding the cecumResults:In Group 3, there was a statistically significant difference in terms of inflammation, lymph node size, and free oxygen radicals; these parameters tended to increase. In terms of fibrosis evaluated using H&E and MT, there was no significant difference between groups 2 and 3.Conclusions:No positive outcomes indicating that Allium sativum reduces intra-abdominal adhesions were obtained. However, it caused severe inflammation in the tissue. Additionally, in immunohistochemical analyses conducted to detect oxidative stress, allium sativum increased the production of free oxygen radicals in the tissue.(AU)

Comportamento da membrana biossintética de celulose como implante peritendíneo em potros / Behavior of cellulose biosynthetic membrane as a peritendinous implant in foals

Background: Tendon injuries are common in horses and are commonly associated with lameness and athletic career disruption.Adhesions formed between the tendons and the surrounding tissues compromise the sliding and movement of the structures,compromising their functionality. Therefore, the control of adhesion formation is critical to restore the structural integrity of thetendon, as well as its biomechanical function. The aim of this study was to evaluate the behavior of the biosynthetic cellulosemembrane implanted in foals with surgically induced tendinitis of the superficial digital flexor.Materials, Methods & Results: Six healthy foals were used, which underwent tendinitis induction in the superficial digital flexorof the right and left forelimbs. The lesions was induced by local ischemia by crushing the tendon with hemostatic forceps. Thebiosynthetic cellulose membrane was implanted only in the right forelimb, involving the superficial digital flexor tendon in theregion of the ischemia and the left forelimb was used as control. After surgery, both forelimb were immobilized with syntheticplaster cast for 15 days. Ultrasonography was performed in six foals immediately before (M0), at 15° (M1) at and 30° (M2) day,and three were evaluate at 45° (M3) and 60° (M4) day after surgery. Incisional biopsies were performed in three animals on the30° day and in three animals on the 60° day after surgery. Histopathological examination involved the analysis of tissue disorganization, presence and type of inflammatory infiltrate and neovascularization, according to the score of 0 to 3. Ultrasonographyallowed visualization of the membrane, which was characterized as a continuous hyperechoic line at the edges of the tendon at15 days (M1). In addition, at 30 and 45 days after surgery, interruption of the hyperechoic line and reduction of echogenicitywere observed, and no echogenic lines were observed at 60 days after surgery...

Avaliação anatomopatológica das complicações da peritonite fecal em equinos tratados com lavagem peritoneal / Anatomopathological evaluation of fecal peritonitis complications in horses treated with peritoneal lavage

Background: Reproductive management in horses when performed with malpractice or by an unqualified person can cause many lesions of various degrees. When the rectum is affected it can compromise the mucous layer of the rectal ampulla and may even cause total perforation of this intestinal segment. Once the rectum ruptured, its contents gets into the abdominal cavity and generates severe abdominal infection, which may cause intense adhesions between organs and even to the abdominal wall and requires a particular intensive intervention. This work reports the use of peritoneal lavage protocol in three horses with septic peritonitis caused by rectal laceration, correlating with post-mortem findings.Cases: Three horses were referred to the Veterinary Hospital Rancho Belo Vista, in the city of Serra - ES, with an accident report during reproductive management in different properties. In all cases, blood loss and loss of continuity of the rectal mucosa were reported by the technicians. Patients were referred at different post-accident times. When they arrived at the hospital, they were examined and a sample of blood and peritoneal fluid were collected and sent to the laboratory. They presented intense apathy, mucosa coloration ranging from hyperemic to pale with halo toxemia, high cardiac and respiratory rate, reduction of globular volume and prolonged time of capillary refill. Patients were given fluid therapy support with lactated Ringer’s solution and systemic therapy protocols such as antibiotic therapy, peritoneal lavage with antibiotic containing solution and anticoagulant, and other supportive treatments were instituted. Peritoneal lavages were instituted every eight hours, in the first 48 hours and every twelve hours, until five days were completed. All patients had to be sacrificed. Euthanasia occurred at different times according to response to treatment and onset of clinical signs of shock.[...]

Avaliação anatomopatológica das complicações da peritonite fecal em equinos tratados com lavagem peritoneal / Anatomopathological evaluation of fecal peritonitis complications in horses treated with peritoneal lavage

Background: Reproductive management in horses when performed with malpractice or by an unqualified person can cause many lesions of various degrees. When the rectum is affected it can compromise the mucous layer of the rectal ampulla and may even cause total perforation of this intestinal segment. Once the rectum ruptured, its contents gets into the abdominal cavity and generates severe abdominal infection, which may cause intense adhesions between organs and even to the abdominal wall and requires a particular intensive intervention. This work reports the use of peritoneal lavage protocol in three horses with septic peritonitis caused by rectal laceration, correlating with post-mortem findings.Cases: Three horses were referred to the Veterinary Hospital Rancho Belo Vista, in the city of Serra - ES, with an accident report during reproductive management in different properties. In all cases, blood loss and loss of continuity of the rectal mucosa were reported by the technicians. Patients were referred at different post-accident times. When they arrived at the hospital, they were examined and a sample of blood and peritoneal fluid were collected and sent to the laboratory. They presented intense apathy, mucosa coloration ranging from hyperemic to pale with halo toxemia, high cardiac and respiratory rate, reduction of globular volume and prolonged time of capillary refill. Patients were given fluid therapy support with lactated Ringers solution and systemic therapy protocols such as antibiotic therapy, peritoneal lavage with antibiotic containing solution and anticoagulant, and other supportive treatments were instituted. Peritoneal lavages were instituted every eight hours, in the first 48 hours and every twelve hours, until five days were completed. All patients had to be sacrificed. Euthanasia occurred at different times according to response to treatment and onset of clinical signs of shock.[...](AU)

The potential efficacy of Survanta (r) and Seprafilm (r) on preventing intra-abdominal adhesions in rats

PURPOSE:To investigate the potential efficacy of beractant (Survanta(r)) and Seprafilm(r) on the prevention of postoperative adhesions.METHODS:Forty Wistar-albino female rats were used. The rats were randomly allocated into four groups of 10 rats each as control group (CG), beractant group (BG), Seprafilm(r) group (SG), and combined group (COG). All rats underwent cecal abrasion via midline laparotomy. Before abdominal closure, isotonic saline, beractant, Seprafilm, and combined agents were intraperitoneally administered. Adhesions were classified macroscopically with Canbaz Scoring System on postoperative day 10. Ceacum was resected for histopathological assessment.RESULTS:Macroscopic adhesion scores were significantly lower in BG, SG, and COG than CG (p<0.05); (45%, 15%, 25%, and 15%; respectively). Histopathological assessment revealed a reduced inflammation and fibrosis score in the study groups than CG (p<0.05). In BG, adhesion development, inflammation and fibrosis scores were lower than SG; however, it was not statistically significant.CONCLUSIONS:Intra-abdominal application of beractant is significantly effective for the prevention of adhesion formation with no adverse effect by covering the whole peritoneal mesothelium with excellent gliding properties in a rat model. The combination of both agents is also effective in reducing adhesion formation, however, not superior to single beractant application.(AU)

Fístula enterocutánea en yegua reporte de um caso / Enterocutaneous fistula in a mare case roport / Fístula enterocutânea em égua relato de caso

Las hernias umbilicales ocurren a menudo en los caballos jóvenes y puede resultar en fístulas estercorales. Entre ellas, la fístula enterocutánea, son por lo general causada por una hernia umbilical. El objetivo fue describir una fístula enterocutánea en equino. Una yegua, castaña, Quarto de Milha, de cinco años de edad, de Paranhos, Mato Grosso do Sul fue servida, cuya referencia histórica fue un aumento de volumen en el ombligo, hace unos años, evolucionando con señales de dolor abdominal y posteriores fuga del contenido intestinal por la hinchazón en el área del orificio. Después de la exploración física, el animal se había convertido en parámetros de alerta y fisiológicas dentro de los límites normales. Al realizar paracentesis que no se encuentro contaminación de la cavidad peritoneal fue recomendado laparotomía exploratoria. Hubo adhesiones en segmento yeyuno a la pared abdominal y optó por la enteroanastomosis terminal final luego enterectomía. Después de 16 días sin complicaciones, el animal mostró señales de dolor abdominal no responsible a los analgésicos. El día 21 de hospitalización el animal murió. En la autopsia, se encontraron con las adherencias que involucran el íleon, ciego y los músculos abdominales, la necrosis intestinal y absceso. A pesar de la falta de literatura sobre el tema tratado, se concluyó que el caso reportado fue una fístula enterocutánea resultante de una hernia umbilical.(AU)

Umbilical hernia often occurs in young horses and may result in stercoral fistula. Among them, enterocutaneous fistula is usually related to umbilical hernia. The objective is to describe a case of enterocutaneous fistula in an equine. A mare, which historic was a swelling in the umbilical scar, a few years ago, evolving with colic and leakage of intestinal contents through the hole in the swollen area. After the physical examination, exploratory laparotomy was recommended. There were adhesions over jejunum segment to the abdominal wall and enterectomy followed by end-to-end enteroanastomosis were opted. After 16 days, without complications, the animal showed signs of colic. On the 21st day the animal died. By necropsy, adhesions involving the ileum, cecum and abdominal muscles, bowel necrosis and abscess were found.(AU)

Hérnias umbilicais ocorrem frequentemente em equinos jovens, podendo resultar em fístulas estercorais. Entre estas, a fístula enterocutânea, é geralmente decorrente de hérnia umbilical. Objetiva-se descrever um caso de fístula enterocutânea em equino. Foi atendida uma égua, castanha, quarto de milha, com cinco anos de idade, proveniente de Paranhos, Mato Grosso do Sul, cujo histórico remetia a um aumento de volume na cicatriz umbilical, há alguns anos, evoluindo com sinais de dor abdominal e posterior extravasamento de conteúdo intestinal por orifício na área do aumento de volume. Após o exame físico, o animal apresentava-se alerta e os parâmetros fisiológicos dentro da normalidade. Ao realizar paracentese, não se constatou contaminação da cavidade peritoneal e foi preconizado a laparotomia exploratória. Observaram-se aderências abrangendo segmento de jejuno à parede abdominal e se optou pela enterectomia seguida de enteroanastomose término-terminal. Após 16 dias sem intercorrências, o animal apresentou sinais de dor abdominal não responsível aos analgésicos. No 21o dia de internação, o animal veio a óbito. Ao exame necroscópico, constataram-se aderências envolvendo íleo, ceco e musculatura abdominal, necrose de alças intestinais e de abscesso. Apesar da escassez da literatura sobre o tema abordado, concluiu-se que o caso relatado se tratava de uma fístula enterocutânea resultante de uma hérnia umbilical.(AU)

Fístula enterocutánea en yegua reporte de um caso / Enterocutaneous fistula in a mare case roport / Fístula enterocutânea em égua relato de caso

Las hernias umbilicales ocurren a menudo en los caballos jóvenes y puede resultar en fístulas estercorales. Entre ellas, la fístula enterocutánea, son por lo general causada por una hernia umbilical. El objetivo fue describir una fístula enterocutánea en equino. Una yegua, castaña, Quarto de Milha, de cinco años de edad, de Paranhos, Mato Grosso do Sul fue servida, cuya referencia histórica fue un aumento de volumen en el ombligo, hace unos años, evolucionando con señales de dolor abdominal y posteriores fuga del contenido intestinal por la hinchazón en el área del orificio. Después de la exploración física, el animal se había convertido en parámetros de alerta y fisiológicas dentro de los límites normales. Al realizar paracentesis que no se encuentro contaminación de la cavidad peritoneal fue recomendado laparotomía exploratoria. Hubo adhesiones en segmento yeyuno a la pared abdominal y optó por la enteroanastomosis terminal final luego enterectomía. Después de 16 días sin complicaciones, el animal mostró señales de dolor abdominal no responsible a los analgésicos. El día 21 de hospitalización el animal murió. En la autopsia, se encontraron con las adherencias que involucran el íleon, ciego y los músculos abdominales, la necrosis intestinal y absceso. A pesar de la falta de literatura sobre el tema tratado, se concluyó que el caso reportado fue una fístula enterocutánea resultante de una hernia umbilical.

Umbilical hernia often occurs in young horses and may result in stercoral fistula. Among them, enterocutaneous fistula is usually related to umbilical hernia. The objective is to describe a case of enterocutaneous fistula in an equine. A mare, which historic was a swelling in the umbilical scar, a few years ago, evolving with colic and leakage of intestinal contents through the hole in the swollen area. After the physical examination, exploratory laparotomy was recommended. There were adhesions over jejunum segment to the abdominal wall and enterectomy followed by end-to-end enteroanastomosis were opted. After 16 days, without complications, the animal showed signs of colic. On the 21st day the animal died. By necropsy, adhesions involving the ileum, cecum and abdominal muscles, bowel necrosis and abscess were found.

Hérnias umbilicais ocorrem frequentemente em equinos jovens, podendo resultar em fístulas estercorais. Entre estas, a fístula enterocutânea, é geralmente decorrente de hérnia umbilical. Objetiva-se descrever um caso de fístula enterocutânea em equino. Foi atendida uma égua, castanha, quarto de milha, com cinco anos de idade, proveniente de Paranhos, Mato Grosso do Sul, cujo histórico remetia a um aumento de volume na cicatriz umbilical, há alguns anos, evoluindo com sinais de dor abdominal e posterior extravasamento de conteúdo intestinal por orifício na área do aumento de volume. Após o exame físico, o animal apresentava-se alerta e os parâmetros fisiológicos dentro da normalidade. Ao realizar paracentese, não se constatou contaminação da cavidade peritoneal e foi preconizado a laparotomia exploratória. Observaram-se aderências abrangendo segmento de jejuno à parede abdominal e se optou pela enterectomia seguida de enteroanastomose término-terminal. Após 16 dias sem intercorrências, o animal apresentou sinais de dor abdominal não responsível aos analgésicos. No 21o dia de internação, o animal veio a óbito. Ao exame necroscópico, constataram-se aderências envolvendo íleo, ceco e musculatura abdominal, necrose de alças intestinais e de abscesso. Apesar da escassez da literatura sobre o tema abordado, concluiu-se que o caso relatado se tratava de uma fístula enterocutânea resultante de uma hérnia umbilical.

Avaliação cirúrgica e laboratorial da utilização de pericárdio homólogo em lesões por abrasão em serosa de cólon maior (flexura pélvica) de equinos / Surgical evaluation and laboratory use of homologous pericardium in serous injuryby abrasion of large colon (pelvic flexure) of horses

Aderências intra-abdominais são complicações de cirurgias de equinos que podem resultar em processos obstrutivos e comprometer a sobrevida dos animais. O presente estudo utilizou dez equinos hígidos, machos, sem raça definida (SRD), com quatro a 15 anos de idade e peso vivo situado entre 300 e 400 quilogramas (kg). Os animais foram submetidos à laparotomia esquerda em estação com o objetivo de serem induzidas aderências, testar a utilização intestinal de membrana biológica de pericárdio como prevenção e avaliar as diferentes alterações sistêmicas e do líquido abdominal. Após sedação e analgesia local, foi utilizado o acesso cirúrgico em grade, na flexura pélvica foi criada uma área de abrasão que, no Grupo 1, foi coberta por pericárdio homólogo e no Grupo 2, lavada com solução fisiológica. Após reposicionamento foi realizada a sutura muscular, de subcutâneo e pele. O pós-operatório constou de avaliações clínicas, citologia do líquido abdominal, hematologia e bioquímica sérica nos momentos M0- pré-operatório e M7, M14, M21 e M28 dias de pós-operatório. Nova laparotomia foi realizada aos 30 dias para verificar aderências, aspecto e biópsia intestinal. A técnica cirúrgica possibilitou menor trauma e campo operatório restrito. A evolução clínica foi satisfatória e cicatriz fibrosa foi identificada entre os planos musculares. Aderências não foram observadas. As avaliações laboratoriais demonstraram aumento de bilirrubinas, hematócrito, monócito, ureia sanguíneos e de proteína, densidade e leucócitos segmentados no líquido peritoneal. Conclui-se que a abrasão foi insuficiente para promover aderências fibrosas. O implante, sem comprovada eficácia, é viável e possível, por não resultar em diferenças laboratoriais significativas ou alterações deletérias.

Intra-abdominal adhesions are equine surgery complications, which can result in obstructive processes and jeopardize the survival of these animals. The present study used 10 healthy, male mongrel horses (SRD), with four and 15 years of age and weighing between 300 and 400 kilograms (kg), who underwent laparotomy left station with the aim of inducing adhesions, test intestinal membrane using pericardium as prevention and evaluating the different systemic changes and the abdominal fluid. After sedation and local anesthesia, the surgical approach was used in grade; pelvic flexure was created in an area of abrasion that in Group 1 was covered by homologous pericardium and in Group 2, washed with saline. After repositioning muscle, the skin and subcutaneous tissue were sutured. Postoperative care consisted of clinical evaluation, abdominal fluid cytology, hematology and serum biochemistry in moments M0- preoperative, and M7, M14, M21 and M28 days postoperatively. New laparotomy was performed at 30 days from the surgery to verify adhesion, appearance and intestinal biopsy. The surgical technique allowed less trauma and restricted operative field. The clinical course was satisfactory, and fibrous scar was identified between the muscle planes. Adhesions were not observed. Laboratory evaluations showed increased bilirubin, hematocrit, monocyte, blood urea and protein density and segmented leukocyte peritoneal fluid. The present study concluded that the abrasion was insufficient to promote fibrous adhesions. The implant without proven efficacy is feasible and possible, and does not result in significant differences laboratory or deleterious changes.

Comparative study of tissue reactivity to n-butyl-2-cyanoacrylate and nylon monofilament thread on pericranium-cutaneous flaps in rats

To study the repair of pericranium-cutaneous flaps fixed with suture anchored in a skull bone tunnel or N-butyl-2-cyanoacrylate adhesive in Wistar rats with emphasis on the cellular inflammatory response and the production of types I and III collagen. The operated region in the cephalic region of Wistar rats was removed minutes before euthanasia, fixed in formalin, and subjected to histological preparation. Slides were stained with hematoxylin-eosin and Picrosirius. Standardized counts of polymorphonuclear and mononuclear cells, fibroblasts, and macrophages were performed, and the percentages of types I and III collagen were determined. Data collection occurred on days 3, 7, 14, 21, and 45 postoperatively. A value of p<0.05 was considered statistically significant. Quantitative analysis of the data showed more fibroblasts in the surgical adhesive group than in the nylon monofilament thread groups (p=0.0211). Qualitative analysis showed higher reactivity in the adhesive group, with a predominance of polymorphonuclear cells from days 3-45 and macrophages from days 3-7. The amount of type I collagen exceeded 80% in the treated and control groups at the end of the experiment. CONCLUSIONS: Subperiosteal detachment triggers a cellular inflammatory response that is amplified using soft tissue fixation methods. The adhesive n-butyl-2-cyanoacrylate was more reactive than the nylon monofilament thread anchored in the skull bone tunnel.(AU)

Comparative study of tissue reactivity to n-butyl-2-cyanoacrylate and nylon monofilament thread on pericranium-cutaneous flaps in rats

To study the repair of pericranium-cutaneous flaps fixed with suture anchored in a skull bone tunnel or N-butyl-2-cyanoacrylate adhesive in Wistar rats with emphasis on the cellular inflammatory response and the production of types I and III collagen. The operated region in the cephalic region of Wistar rats was removed minutes before euthanasia, fixed in formalin, and subjected to histological preparation. Slides were stained with hematoxylin-eosin and Picrosirius. Standardized counts of polymorphonuclear and mononuclear cells, fibroblasts, and macrophages were performed, and the percentages of types I and III collagen were determined. Data collection occurred on days 3, 7, 14, 21, and 45 postoperatively. A value of p<0.05 was considered statistically significant. Quantitative analysis of the data showed more fibroblasts in the surgical adhesive group than in the nylon monofilament thread groups (p=0.0211). Qualitative analysis showed higher reactivity in the adhesive group, with a predominance of polymorphonuclear cells from days 3-45 and macrophages from days 3-7. The amount of type I collagen exceeded 80% in the treated and control groups at the end of the experiment. CONCLUSIONS: Subperiosteal detachment triggers a cellular inflammatory response that is amplified using soft tissue fixation methods. The adhesive n-butyl-2-cyanoacrylate was more reactive than the nylon monofilament thread anchored in the skull bone tunnel.

The application of percutaneous lysis of epidural adhesions in patients with failed back surgery syndrome / A aplicação da lise percutânea de aderências epidurais em pacientes com síndrome pós-laminectomia

PURPOSE: To investigate the efficacy and the feasibility of application of percutaneous lysis of epidural adhesions in failed back surgery syndrome (FBSS) using a stiff type guide wire and 4F vascular catheter. METHODS: Ninety two patients with FBSS were randomly divided into two groups, the control group (treated by injection dexamethasone only) and percutaneous lysis of epidural adhesions group. Visual analog scale scores (VAS) and therapeutic evaluation were observed in the preoperative, seven days postoperative, one month and six months postoperative. RESULTS: VAS scores for pain were significantly reduced in both groups at seven days. The VAS scores were in controlled group at one month, six months was significantly higher than that in epidural lysis group. However, there was no statistical difference in VAS scores of one month and six months when respectively compared to that of before operation in controlled group. Patients on epidural lysis reported clinical effectiveness rate was 50%. Patients on control was 5.26%, there was a statistical difference between two groups. CONCLUSION: Percutaneous lysis of epidural adhesions by using a stiff type guide wire and 4F vascular catheter is an effective method in the treatment of FBSS and it has a value in clinical application.(AU)

OBJETIVO: Investigar a eficácia e a exequibilidade da aplicação da lise percutânea de aderências epidurais na síndrome pós-laminectomia usando um fio-guia tipo Stiff e um cateter vascular 4F. MÉTODOS: Noventa e dois pacientes com síndrome pós-laminectomia foram randomizados em dois grupos: grupo controle (tratado somente com injeção de dexametazona) e grupo lise percutânea de aderências epidurais. Escores de escala visual analógica (VAS) e avaliação terapêutica foram observadas no pré-operatório, no sétimo dia de pós-operatório, um mês e seis meses de pós-operatório. RESULTADOS: Escores VAS para dor foram significantemente reduzidos em ambos os grupos aos sete dias. Os escores VAS foram mais altos no grupo controle comparado ao da lise epidural nos tempos de um mês e seis meses. Entretanto, não há diferença estatística nos escores VAS de um mês e seis meses quando comparados, respectivamente, àqueles de antes da operação do grupo controle. Pacientes com a lise epidural relataram taxa de eficiência de 50%. Nos pacientes do grupo controle foi 5,26%, havendo diferença estatística entre os dois grupos. CONCLUSÃO: A lise percutânea de aderências epidemias usando um fio-guia tipo Stiff e um cateter vascular 4F mostrou-se um método efetivo no tratamento de FBSS e tem valor na aplicação clínica.(AU)

Cistolitectomia e ressecção de cisto renal por laparoscopia em uma cadela com aderências intraperitoneais: relato de caso / Cystolithectomy and renal cyst resection by laparoscopic surgery in a female dog with intraperitoneal adhesions: case report

No presente relato descreve-se a remoção de urólitos vesicais, bem como o tratamento de um cisto renal por cirurgia laparoscópica em um cão com aderências intraperitoneais. Para o acesso foram utilizados três portais, dois de 10mm e um de 5mm, dispostos na linha média ventral e nas paredes abdominal direita e esquerda. Após a remoção das litíases, realizou-se sutura intracorpórea da parede vesical em duas camadas. O cisto renal direito foi drenado e sua cápsula extirpada. Ocorreu a perda temporária de um urólito na cavidade abdominal e sua posterior recuperação pela cirurgia laparoscópica. O paciente não apresentou recidiva da doença pelo período mínimo de 14 meses. A cirurgia laparoscópica mostrou-se eficaz na terapêutica de ambas as patologias, sem a necessidade de alteração do posicionamento dos portais.(AU)

This study reports the laparoscopic treatment of urolithys and renal cist in a dog with adherences after laparotomy. Three portals (two with 10mm and one with 5mm) were used in the middle ventral line or lateral flanks. The calculi were removed, and two intracorporeal sutures were made in the vesicle tissue. The right cystic tissue was drained and its capsule was extirpated. One calculus was lost in the peritoneal cavity, but later recovered by laparoscopy. The patient did not show urinary vesicle disease during at least 14 months. The laparoscopic cistotomy appears to be adequate to remove urolithys and to treat renal cystic disease in dogs.(AU)

Cistolitectomia e ressecção de cisto renal por laparoscopia em uma cadela com aderências intraperitoneais: relato de caso / Cystolithectomy and renal cyst resection by laparoscopic surgery in a female dog with intraperitoneal adhesions: case report

No presente relato descreve-se a remoção de urólitos vesicais, bem como o tratamento de um cisto renal por cirurgia laparoscópica em um cão com aderências intraperitoneais. Para o acesso foram utilizados três portais, dois de 10mm e um de 5mm, dispostos na linha média ventral e nas paredes abdominal direita e esquerda. Após a remoção das litíases, realizou-se sutura intracorpórea da parede vesical em duas camadas. O cisto renal direito foi drenado e sua cápsula extirpada. Ocorreu a perda temporária de um urólito na cavidade abdominal e sua posterior recuperação pela cirurgia laparoscópica. O paciente não apresentou recidiva da doença pelo período mínimo de 14 meses. A cirurgia laparoscópica mostrou-se eficaz na terapêutica de ambas as patologias, sem a necessidade de alteração do posicionamento dos portais.

This study reports the laparoscopic treatment of urolithys and renal cist in a dog with adherences after laparotomy. Three portals (two with 10mm and one with 5mm) were used in the middle ventral line or lateral flanks. The calculi were removed, and two intracorporeal sutures were made in the vesicle tissue. The right cystic tissue was drained and its capsule was extirpated. One calculus was lost in the peritoneal cavity, but later recovered by laparoscopy. The patient did not show urinary vesicle disease during at least 14 months. The laparoscopic cistotomy appears to be adequate to remove urolithys and to treat renal cystic disease in dogs.