Hepaticojejunostomy for treatment of common hepatic duct obstructions associated with duodenal stenosis in two foals.
Abstract: Two female Standardbred foals 2 and 3 months of age were presented with signs of gastroduodenal obstruction that was confirmed with contrast radiography and exploratory surgery. Ventral midline celiotomy was performed, showing stenosis of the duodenum proximal and distal to the hepatopancreatic ampulla. The common hepatic duct, the pancreatic duct, and the sigmoid section of the duodenum proximal to the stenosis were greatly dilated. To bypass the intestinal obstruction, a side-to-side duodenojejunostomy was performed. Obstruction of the common hepatic duct was relieved by side-to-side hepaticojejunostomy. In addition, jejunojejunostomy was performed distal to the other anastomoses. Both foals recovered. On admission, the foals' total bilirubin, aspartate aminotransferase, and gamma glutamyl transferase levels were greatly elevated. During the subsequent 6 to 8 months, they returned to normal. Six months after the first surgery, one foal was readmitted with an acute abdominal crisis. At surgery, there was greater than 360 degrees clockwise rotation of the mesenteric root involving most of the jejunum. At necropsy, the previously created stomas were patent. The liver and bile duct were grossly and histologically normal. The second foal continues to progress normally 12 months after surgery.
Publication Date: 1989-01-01 PubMed ID: 2564707DOI: 10.1111/j.1532-950x.1989.tb01040.xGoogle Scholar: Lookup
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Summary
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The study provides insights into the medical treatment of two female foals diagnosed with gastroduodenal obstruction through the surgical procedure of Hepaticojejunostomy. The treatment not only resolved the issue of obstruction but also helped normalize the body functions, evidenced by the normalizing levels of total bilirubin, aspartate aminotransferase, and gamma glutamyl transferase post-treatment.
Research Background and Method
- The research focuses on treatment of common hepatic duct obstructions in two young foals.
- The foals presented symptoms of gastroduodenal obstruction which was later confirmed through contrast radiography and exploratory surgery.
- Major observations from the exploration surgery included the dilation of the common hepatic duct, pancreatic duct, and a section of the duodenum proximal to the stenosis.
Procedure and Outcome
- The medical treatment involved different complex surgical procedures including ventral midline celiotomy, side-to-side duodenojejunostomy, side-to-side hepaticojejunostomy, and jejunojejunostomy which were performed to bypass the intestinal obstruction and to relieve the obstructed common hepatic duct.
- All of these operations ultimately resulted in the successful recovery of both foals.
- The recovery was not immediate, but the full recuperation was evident in the normalization of the foals’ total bilirubin, aspartate aminotransferase, and gamma glutamyl transferase levels after 6 to 8 months.
Further Observations and Outcome
- Six months after the initial surgery, one of the foals was readmitted due to an acute abdominal crisis. This was caused by a significant clockwise rotation of the mesenteric root involving most of the jejunum.
- Despite the complication, the autopsy showed the created stomas were patent and the liver and bile duct were in normal condition.
- The other foal continued to progress normally even 12 months after the surgery, further confirming the success of the surgical treatment.
Cite This Article
APA
Orsini JA, Donawick WJ.
(1989).
Hepaticojejunostomy for treatment of common hepatic duct obstructions associated with duodenal stenosis in two foals.
Vet Surg, 18(1), 34-38.
https://doi.org/10.1111/j.1532-950x.1989.tb01040.x Publication
Researcher Affiliations
- Section of Surgery, University of Pennsylvania School of Veterinary Medicine, Kennett Square 19348-1692.
MeSH Terms
- Anastomosis, Surgical / veterinary
- Animals
- Aspartate Aminotransferases / blood
- Bilirubin / blood
- Cholestasis, Extrahepatic / etiology
- Cholestasis, Extrahepatic / surgery
- Cholestasis, Extrahepatic / veterinary
- Common Bile Duct / surgery
- Common Bile Duct Diseases / etiology
- Common Bile Duct Diseases / surgery
- Common Bile Duct Diseases / veterinary
- Duodenal Obstruction / complications
- Duodenal Obstruction / surgery
- Duodenal Obstruction / veterinary
- Duodenum / surgery
- Female
- Horse Diseases / surgery
- Horses
- Jejunum / surgery
- Postoperative Care / veterinary
- Suture Techniques / veterinary
- gamma-Glutamyltransferase / blood
Citations
This article has been cited 1 times.- Buote M. Cholangiohepatitis and pancreatitis secondary to severe gastroduodenal ulceration in a foal. Can Vet J 2003 Sep;44(9):746-8.
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