Jejunal strangulation and incarceration associated with bilateral perineal hernias in a neutered male dog

CASE DESCRIPTION An 8-year-old 6.8-kg neutered male Dachshund was presented for evaluation of vomiting, diarrhea, anorexia, and swelling over the right perineal region. The dog had a history of a bilateral perineal herniorrhaphy and castration 14 months prior to presentation. CLINICAL FINDINGS Bilateral perineal hernias were confirmed by digital rectal examination. Abdominal ultrasonography confirmed the presence of intestine within the right hernia. Three days after admission to the hospital, the region of the right perineal hernia became painful, erythematous, and edematous. Computed tomography revealed jejunal incarceration within the right hernia with dilation of 1 jejunal segment that indicated intestinal obstruction. TREATMENT AND OUTCOME Abdominal exploratory surgery was performed, during which irreducible small intestinal incarceration was confirmed. Intra-abdominal jejunal resection and anastomosis was performed, and an approximately 13-cm-long section of the jejunum was resected. Bilateral perineal herniorrhaphies with internal obturator and superficial gluteal muscle transposition were performed. Six months after surgery, digital rectal examination of the dog revealed that the repair was intact. The dog had no perineal hernia–related clinical signs at the time of the recheck examination. CLINICAL RELEVANCE For the dog of the present report, surgical management of small intestinal strangulation associated with a perineal hernia was successful. Although a portion of the small intestines can frequently be found within perineal hernias in dogs, perineal hernia-related small intestinal strangulation has not been previously described, to the authors’ knowledge. Veterinarians and clients should be aware of this potential complication secondary to perineal hernia and be prepared to perform an abdominal surgical procedure to address small intestinal incarceration in affected dogs.

Torsion of the Vascular Pedicle of A Wandering Spleen: An Unusual Cause of Intestinal Strangulation

Ectopic spleen is a rare splenic malformation. Apart from torsion of the vascular pedicle, a common complication, an ectopic spleen could be responsible of an acute intestinal obstruction. We report a case of an 8-year-old girl who presented an acute abdomen, following of the transverse colon strangulation by the torsion of the vascular pedicle of a wandering spleen. The patients benefited a surgical opening into the abdomen who has been confirmed the diagnosis and made a detorsion of the vascular pedicle of spleen with splenopexy.The interest of this case report lies on the rarity of a wandering spleen and on the unusual situation of transverse colon strangulation by the vascular pedicle of spleen.

Influence of Intestinal Strangulation Release on Ischemiareperfusion Injury in Sprague Dawley Rats

Background: In intestinal ischemia, reperfusion towards the injured intestine can cause further injury to the intestine itself and to remote organs. This research aimed to evaluate the influence of intestinal strangulation release (SR) before resection on the intestine outside margin of the strangulated intestine compared with subjects without intestinal strangulation release (WSR). Methods: Fourteen male Sprague Dawley rats were subjected to strangulation of one loop of the distal ileum for 4 h. In the SR group, the strangulated intestine was released for 5 min and then resected for necrotic parts. In the WSR group, the strangulated intestine was immediately resected WSR. The control group received a sham laparotomy. Four hours after the second laparotomy, the animals weresacrificed, and intestinal samples were taken for histomorphological analysis and measurement of intestinal malondialdehyde (MDA) level. Results: The injury on the histomorphological intestinal mucosa and intestinal MDA level were insignificantly higher in the SR group than in the WSR group (p>0.05). Conclusion: Intestinal SR before resection causes more tissue injury and oxidative stress on the intestine outside the strangulationsection, but the difference is not statistically significant. Keywords: Ischemia-reperfusion injury, Intestinal ischemia, Intestinal strangulation release, Malondialdehyde, Intestine injury

An atypical presentation of a mesenteric Meckel’s diverticulum in a 7-year-old warmblood mare: case report

Background Meckel’s diverticula are a rare cause of small intestinal strangulation, diagnosed at laparotomy or necropsy. This congenital anomaly of the gastrointestinal tract originates from a remnant of the vitelline duct. In reported equine cases, they present as a full-thickness diverticulum on the antimesenteric border of the distal jejunum or proximal ileum. Case presentation On laparotomy a Meckel’s diverticulum positioned at the mesenteric side was found to be the cause of small intestinal strangulation. This position is very uncommon and to the best knowledge of the authors there is no unambiguous description of another case. Conclusions Meckel’s diverticula should be on the list of differential diagnoses in cases of small intestinal strangulation. As in humans, equine Meckel’s diverticula can have the standard antimesenteric as well as a more exceptional mesenteric location. This case adds to the series of anecdotal reports of anomalies with regard to Meckel’s diverticula in the horse.

MORPHOLOGICAL CHANGES OF THE SMALL INTESTINE IN ACUTE STRANGULATIVE INTESTINAL OBSTRUCTION IN THE STAGE OF DECOMPOSITION IN CHILDREN

Purpose. The purpose was to determine the depth and prevalence of pathomorphological changes in the small intestine of children at the distance from the visible border of necrosis with decompensated acute strangulated intestinal obstruction (ASIO) to determine the minimum possible length of intestinal resection.Material and methods. Morphological studies of a resected fragment of the small intestine were performed in 24 children aged 3 days to 18 years who had undergone a surgery for ASIO with intestinal necrosis. Strangulated adhesive obstruction was found in 17 children, five children had congenital intestine torsion and two children faced small intestinal strangulation in the congenital mesenteric defect. The postsurgical material was studied morphologically using histological stains with the distance of 3 cm between the section.Results. The depth, prevalence of the morphological changes in the small intestinal wall, intensity and length of morphological changes in children with decompensated ASIO were determined.Conclusion. A differentiated approach to the selection of resection scope in the proximal and distal directions from the visible border of ASIO-related necrosis is necessary. The distances are twice shorter in children as compared to adults. Refusal from extensive resections will enable to reduce the rate of short bowel syndrome in children.