Clinical and surgical evaluation of Perineal Hernia in dogs: 41 cases Pekcan, Z., Kırıkkale University, Faculty of Veterinary Medicine, Kırıkkale (Turkey). Div. of Surgery; Besalti, Ö., Ankara Univ., Faculty of Veterinary Medicine, Ankara (Turkey). Div. of Surgery; Şirin, Y.S., Mehmet Akif Ersoy Univ., Faculty of Veterinary Medicine, Burdur (Turkey). Div. of Surgery ...
Veteriner fakultesi dergisi,
(2010), Volume:
16, Issue:
4
Journal Article
Peer reviewed
Open access
The purpose of the study was to report the clinical and surgical records of perineal hernia and associated rectal pathology with epidural morphine analgesia in 41 dogs. Fourty one dogs suffered from ...perineal hernia were included into the study with the age varied from 4.5 to 16 years. Eleven dogs had bilateral while the other 30 had unilateral (17 right, 13 left) perineal hernia. The clinical signs were perianal swelling (n=41), severe tenesmus (n=19), dyschesia (n=9), proctitis (n=7), fecal incontinence (n=4), stranguria (n=2) and hematuria (n=1). Associated rectal pathologies were diverticulation (n=15), dilatation (n=4), deviation (n=3) and sacculation (n=1). The rectal diverticulum was corrected by extraluminal plication (n=12) or rectal resection (n=3). Internal obturator muscle flap transposition was used to repair the hernia in all cases. Postoperative pain was subjectively evaluated and scores were 'no pain' in 10 cases, mild in 28 cases, moderate in 3 cases. Mean follow-up time was 27.3 months (range 4 months to 5 years) and the recurrence was observed only in three cases postoperatively. In conclusion, combined perineal herniorraphy with internal obturator muscle transposition and rectal wall repairment can be carried out at the same time and epidural morphine administration provide adequate analgesia for these operations.
Bu çalışmanın amacı 41 köpekte perineal herni ve eşlik eden rektal patolojilerin klinik ve operatif bulgularını postoperatif ağrı skorları ile birlikte sunmaktır. Perineal herni tanısı konulan, yaşları 4.5 ile 16 arasında değişen 41 köpek çalışma kapsamına alındı. 11 köpekte bilateral, 30 köpekte unilateral (17 sağ, 13 sol) perineal herni tespit edildi. Klinik semptomlar perineal şişkinlik (n=41), şiddetli tenesmus (n=19), ağrılı defekasyon (n=9), proktitis (n=7), fekal inkontinens (n=4), stranguri(n=2) ve hematuri (n=1) idi. Bunlara eşlik eden rektal patolojiler divertikülasyon (n=15), dilatasyon (n=4), deviasyon (n=3) ve sakkulasyon (n=1) idi. Rektal divertikülasyon ekstraluminal plikasyon (n=12) veya rektal rezeksiyon (n=3) ile düzeltildi. Perineal herninin onarımında tüm olgularda internal obturator kas flebi kullanıldı. Postoperatif ağrı subjektif olarak değerlendirildi. Buna göre 10 olguda ağrının olmadığı, 28 olguda hafif ve 3 olguda orta düzeyde ağrı olduğu kaydedildi. Ortalama 27.3 aylık (4 ay-5 yıl) takip süresinde 3 olguda nüks tespit edildi. Sonuç olarak, internal obturator kas flebi ile perineal herninin onarılabileceği, aynı operasyonda rektal duvar patolojilerinin düzeltilebileceği ve bu operasyonlarda epidural morfin uygulamasının yeterli düzeyde analjezi sağladığı kaydedildi.
Aim: In this work, failed back surgery syndrome(FBSS) which observed in
Lomber disc herniation(DH) postoperatively is analysed; and especially
epidural fibrosis and recurrent cases are ...retrospectively analysed
through calculating the success scores. Method: Our work had been
carried out between January/2000 - December/2006. In our clinic,
1268 cases in total were examined that were operated by reason of
lomber disc herniation in our clinic. Among the cases that were
included to the study, the 70 were evaluated as FBSS and the
radiological evidences, surgical and clinical findings were analysed
retrospectively. Result: Of all the patients 36 were women (51%), the
34 were male (48.6 %). Their ages changed between 22-74 and the age
average was found as 49.9. Of all the reoperated cases; the 45 (64%)
were reoperated by reason of recurrent DH, 9 (12.8%) epidural fibrosis
and recurrent DH, 8 (11.4% ) paraspinal abse, 3 (4.2%) lomber stenosis,
3 (4.2%) foraminal stenosis, 1 (1.4%) postoperative discitis, 1(1.4%)
Cerebro spinal fluid (CSF) fistule. While the success rate of the cases
with epidural fibriosis was found as 37.2 % ; 75.9% success rate was
recorded for the patients with recurrent DH. Statistical comparison was
found as meaningful. (p< 0.05) Conclusion: The most frequent
reoperation cause for the patients who were operated by reason of
lomber DH is the recurrent herniations which occur at the same level;
the same side or the opposite side. The cases with epidural fibriosis
must be well-assessed radiologically and clinically and the most
effective treatment plan should be aimed and formed.
Three patients with acute lymphoblastic leukemia (ALL) developed mononuclear cells in the cerebrospinal fluid (CSF) after a flu-like history during maintenance treatment. None of the patients showed ...evidence of central nervous system (CNS) involvement by either clinical or laboratory follow-up. Although the presence of > 5 mononuclear cells/microl in the CSF is important, it may not necessarily indicate CNS disease. Clinical findings, history and cell morphology must be evaluated before deciding on further treatment.
