Duodenal obstruction caused by duodenal sigmoid flexure volvulus in dairy cattle: 29 cases (2006-2010).
OBJECTIVE
To characterize duodenal sigmoid flexure volvulus (DSFV) and determine the prognosis for affected cattle undergoing surgery.


METHODS
Retrospective case series.


METHODS
29 dairy cattle.


METHODS
The medical records were analyzed for history, signalment, clinical signs, medical management, surgical findings, and outcome.


RESULTS
29 cattle were determined to have DSFV between December 2006 and August 2010. Twenty cattle had had an omentopexy or pyloropexy performed 1 day to 2 years before initial evaluation. Cattle were afebrile, tachycardic, and moderately dehydrated, with a small zone of percussion with a ping at the 10th to 12th right intercostal spaces and associated succussion. Biochemical changes were a severe hypokalemic (mean ± SD, 2.9 ± 0.5 mmol/L; median, 3.1 mmol/L; range, 2.08 to 3.92 mmol/L), hypochloremic (mean, 69.7 ± 11.1 mmol/L; median, 71.7 mmol/L; range, 49.1 to 94.1 mmol/L) metabolic alkalosis (mean total CO(2), 44.5 ± 7.4 mmol/L; median, 45.3 mmol/L; range, 31.5 to 59.6 mmol/L) and hyperbilirubinemia (mean, 32.4 ± 29.0 μmol/L; median, 20.5 μmol/L; range, 7.8 to 107 μmol/L). Surgical findings for DSFV included an empty descending duodenum adjacent to a dorsally displaced and dilated cranial segment of the duodenum, distended abomasum and gallbladder, and a tight volvulus at the base of the duodenal sigmoid flexure. Manual reduction was considered successful if the descending duodenum filled after cranial duodenal massage. Twenty-two patients were successfully treated; the remaining 7 died or were euthanized within 4 days after surgery.


CONCLUSIONS
A condition clinically resembling abomasal volvulus but affecting the duodenal sigmoid flexure has been recognized in dairy cattle. When a focal, dorsal right-sided ping and succussion are present combined with severe hypokalemic, hypochloremic metabolic alkalosis and high bilirubin concentration, DSFV should be suspected, especially when there is a history of prior abomasal fixation. After surgical correction, the prognosis is fair to good.
Farm Animal Hospital, Faculté de Médecine Vétérinaire, Université de Montréal, CP 5000, St-Hyacinthe, QC, Canada. svogel@medinst.com
Susan R
SR
Vogel
Sylvain
S
Nichols
Sébastien
S
Buczinski
André
A
Desrochers
Marie
M
Babkine
Manon
M
Veillette
David
D
Francoz
Elizabeth
E
Doré
Gilles
G
Fecteau
Anne-Marie
AM
Bélanger
Mauricio
M
Badillo
D000818:Animals; D002417:Cattle; D002418:Cattle Diseases / Q000175:diagnosis* / Q000601:surgery; D004380:Duodenal Obstruction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery / Q000662:veterinary*; D005260:Female; D045822:Intestinal Volvulus / Q000150:complications / Q000175:diagnosis / Q000601:surgery / Q000662:veterinary*; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome