Surgical Management of Ruminal Perforation in a Bullock.
Fistulas of compound stomach have been frequently observed and usually associated with trauma (Sharma et al, 2011). However, Costa et al. (2002) reported injuries causing fistulas associated mostly with abomasum. So far, there has been several reports of ruminal fistula viz. due to horn gore (Deviprasad et al, 2014, Braun et al., 2016) and accidental penetration of iron rod (Singh et al, 2016). Our report deals with trauma caused by a sharp wooden stick, penetrating the rumen and extended caudally upto the dorsal of scrotal sac and recovery following surgical management.
History and Diagnosis
A bullock aged approximately two years was presented with an external penetrating wound on left flank near seventh intercostal space and distal bulging near scrotal sac. After manual palpation, it was ascertained that a long object was lodged inside the peritoneal cavity and distal end of same object extends to dorsal of scrotal sac. Emergency surgical intervention was planned to remove the object.
Animal was sedated with Xylazine 0.03 mg/kg I/M, and restrained to right lateral recumbency. The site was prepared aseptically. Lignocaine hydrochloride 2% was infiltrated locally at the site of incision in linear manner. A 20 cm long incision was made vertically in mid paralumber fossa for exploratory laparotomy. Standard rumenotomy was performed. Manual evacuation of ruminal contents was done to locate the foreign body. A sharp wooden stick was located and its track was palpated manually to ascertain any other piercing trauma. However due to it's length, it was not possible manually to trace entire length of stick. Therefore, it was decided to incise skin at distal end protrusion. An incision was given approx. 8 cms dorsal to scrotal sac to expose the caudal penetrating end of stick. It was observed that stick pierced the rumen and rests on underlying tissues.
The stick was removed through distal end by traction. The length of stick was approximately two feet. The ruminal fistula was closed with two rows of continuous inverting sutures using chromic catgut no.2. At rumenotomy site, all fixation sutures were removed and again the shrunken rumen wall was explored to locate the proximal ruminal fistula caused by penetration of stick. The rumenotomy and laparotomy incision were closed in routine manner by chromic cat gut no. 2. The external skin wound caused by trauma was also cleaned aseptically and closed by applying interrupted suture pattern with black braided silk no. 2.
Skin wounds were dressed aseptically with Povidine Iodine and Inj. Dicrysticin (a) (Strepto-penicillin) 2.5 gm I/M and Inj. Melonex (b) (Meloxicam) 30 ml I/M daily were administered post-operatively for seven days. Skin sutures were removed on twelfth day and animal had an uneventful recovery.
There has been several reports available on surgical management of ruminal fistula due to various traumatic injuries by metallic object (Prakash and Ravi, 2009), ruminal fistula along with impaction due to plastic sheets, wires and twisted ropes (Ramesh Kumar et al., 2000), horn gore injury (Devi Prasad et al., 2014). However, in all previous reports, external agent causing trauma had not penetrated so deeply and remain lodged inside the rumen. Whereas in our case, the wooden stick perforated caudal part of dorsal rumen and passed through abdominal cavity close to visceral peritoneum avoiding intestinal loops and mesentery then buldged at the dorsal of scrotal sac. Thus, the report features the emergency surgical management of foreign body injury to rumen.
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Babita Das (1), Apra Shahi (2) and Shobha Jawre (2)
Department of Veterinary Surgery and Radiology
College of Veterinary Science and Animal Husbandry
Nanaji Deshmukh Veterinary Science University (NDVSU)
Jabalpur - 482001 (Madhya Pradesh)
(1.) Assistant Professor and Corresponding author. E-mail: firstname.lastname@example.org
(2.) Associate Professor
(a) - Brand of Zydus Animal Health Ltd., Ahmedabad.
(b) - Brand of Intas Animal Health, Ahmedabad.
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|Title Annotation:||Short Communication|
|Author:||Das, Babita; Shahi, Apra; Jawre, Shobha|
|Date:||Jan 1, 2018|
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