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Pyloro-duodenal hernia with formation of enterocutaneous fistula in a buffalo calf following a dog attack.

Kamalakar G, Prasad VD, Devaratnam J, Ganeshan A - Open Vet J (2015)

Bottom Line: A body wall hernia entrapping abomasum and concurrent duodenal fistula in a buffalo calf aged about 8 months, secondary to a dog bite was successfully treated by closure of fistulous orifice and ventro lateral herniorrhaphy.

View Article: PubMed Central - PubMed

Affiliation: Department of Veterinary Surgery and Radiology, College of Veterinary Science, Proddatur, Andhra Pradesh, India, 516360.

ABSTRACT
A body wall hernia entrapping abomasum and concurrent duodenal fistula in a buffalo calf aged about 8 months, secondary to a dog bite was successfully treated by closure of fistulous orifice and ventro lateral herniorrhaphy.

No MeSH data available.


Related in: MedlinePlus

Separation of adhesions between abomasum and lesser omentum.
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Figure 4: Separation of adhesions between abomasum and lesser omentum.

Mentions: The calf was administered with 2.5 liters of Ringer’s Lactate solution and injected with Ketoprofen at a dose of 2 mg/kg BW I/V for rehydration and as preemptive analgesia respectively. After preparing surgical area aseptically, the calf was sedated with xylazine hydrochloride at a dose of 0.01 mg/kg BW and local analgesia was achieved by inverted L block using 2% lignocaine hydrochloride. The dry gangrenous skin flap was excised and fistulous orifice was closed with a sterile pledget to avoid contamination. A hernial ring (Fig. 3) measuring 7 X 10 cm with its cranial border formed by 12th rib was found on lifting the herniated contents. The area was thoroughly irrigated with normal saline to clear the pus and necrotic tissue. By blunt and fine dissection the adhesions between the skin and abomasum, abomasum and lesser omentum (Fig. 4) were broken with the help of a scrubbed assistant to hold the organs and leaving them back only if the serosa at the place of adhesion was intact. However there were no serosal perforations. It was found that the fistula was just caudal to pyloro-duodenal junction at cranial duodenum even before portal flexure. The serosal layer of the part surrounding the fistula and pyloric antrum appeared excoriated and ulcerated. The inflamed edges of the fistulous opening were bevelled out (Fig. 5). The fistula was closed by single layered interrupted Lembert sutures with chromic catgut No. 1/0. Whole viscera were irrigated with normal saline and metronidazole and repositioned in to the abdomen. The edges of the hernial ring were trimmed and closed with chromic catgut No. 2 in simple continuous pattern super imposed by simple interrupted sutures. There was no much tension on the closure of the hernial ring. The necrosed tissue was scarified and skin edges were freshened and closed with sterile braided black silk in horizontal mattress pattern which was best known aversion suture pattern for closure of skin incision. Suture line was smeared with lorexane ointment (Gamma benzene hexachloride, Proflavin hemisulphate and Cetrimide cream). Post operatively, 500 ml normal saline, 500 ml Ringer’s Lactate solution, 100 ml metronidazole I/V, 500 mg inj. ceftriaxone, 5 ml inj. Tribivet and 5 ml chlorpheniramine maleate (anti histamine) I/M were administered and this regimen was followed for the next 5 days. With appropriate fluid and anti-bacterial therapy and proper post-operative care the calf recovered uneventfully. Cutaneous sutures were removed on 12th post-operative day. No complications were observed till 4 months post-surgery.


Pyloro-duodenal hernia with formation of enterocutaneous fistula in a buffalo calf following a dog attack.

Kamalakar G, Prasad VD, Devaratnam J, Ganeshan A - Open Vet J (2015)

Separation of adhesions between abomasum and lesser omentum.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663805&req=5

Figure 4: Separation of adhesions between abomasum and lesser omentum.
Mentions: The calf was administered with 2.5 liters of Ringer’s Lactate solution and injected with Ketoprofen at a dose of 2 mg/kg BW I/V for rehydration and as preemptive analgesia respectively. After preparing surgical area aseptically, the calf was sedated with xylazine hydrochloride at a dose of 0.01 mg/kg BW and local analgesia was achieved by inverted L block using 2% lignocaine hydrochloride. The dry gangrenous skin flap was excised and fistulous orifice was closed with a sterile pledget to avoid contamination. A hernial ring (Fig. 3) measuring 7 X 10 cm with its cranial border formed by 12th rib was found on lifting the herniated contents. The area was thoroughly irrigated with normal saline to clear the pus and necrotic tissue. By blunt and fine dissection the adhesions between the skin and abomasum, abomasum and lesser omentum (Fig. 4) were broken with the help of a scrubbed assistant to hold the organs and leaving them back only if the serosa at the place of adhesion was intact. However there were no serosal perforations. It was found that the fistula was just caudal to pyloro-duodenal junction at cranial duodenum even before portal flexure. The serosal layer of the part surrounding the fistula and pyloric antrum appeared excoriated and ulcerated. The inflamed edges of the fistulous opening were bevelled out (Fig. 5). The fistula was closed by single layered interrupted Lembert sutures with chromic catgut No. 1/0. Whole viscera were irrigated with normal saline and metronidazole and repositioned in to the abdomen. The edges of the hernial ring were trimmed and closed with chromic catgut No. 2 in simple continuous pattern super imposed by simple interrupted sutures. There was no much tension on the closure of the hernial ring. The necrosed tissue was scarified and skin edges were freshened and closed with sterile braided black silk in horizontal mattress pattern which was best known aversion suture pattern for closure of skin incision. Suture line was smeared with lorexane ointment (Gamma benzene hexachloride, Proflavin hemisulphate and Cetrimide cream). Post operatively, 500 ml normal saline, 500 ml Ringer’s Lactate solution, 100 ml metronidazole I/V, 500 mg inj. ceftriaxone, 5 ml inj. Tribivet and 5 ml chlorpheniramine maleate (anti histamine) I/M were administered and this regimen was followed for the next 5 days. With appropriate fluid and anti-bacterial therapy and proper post-operative care the calf recovered uneventfully. Cutaneous sutures were removed on 12th post-operative day. No complications were observed till 4 months post-surgery.

Bottom Line: A body wall hernia entrapping abomasum and concurrent duodenal fistula in a buffalo calf aged about 8 months, secondary to a dog bite was successfully treated by closure of fistulous orifice and ventro lateral herniorrhaphy.

View Article: PubMed Central - PubMed

Affiliation: Department of Veterinary Surgery and Radiology, College of Veterinary Science, Proddatur, Andhra Pradesh, India, 516360.

ABSTRACT
A body wall hernia entrapping abomasum and concurrent duodenal fistula in a buffalo calf aged about 8 months, secondary to a dog bite was successfully treated by closure of fistulous orifice and ventro lateral herniorrhaphy.

No MeSH data available.


Related in: MedlinePlus