Bilateral hydronephrosis and hydroureter after ovariohysterectomy using nylon cable tie: a case report

Abstract

ABSTRACT:A spayed crossbred female dog was presented due to progressive weight loss, emesis and anorexia over the preceding month. A complete blood count, urinalysis, serum biochemical panel, and ultrasound were initially performed. Computed tomography urography was performed as a complementary exam. Based on ultrasound and CT findings an exploratory celiotomy was performed to remove hyperdense structures that could be the cause of the hydronephrosis and hydroureter in both kidneys. An extensive granulomatous reaction was found near the caudal pole to the left kidney. A nylon cable tie adhering firmly to this tissue was removed during surgical excision. On the dorsal surface of the bladder an extensive granulomatous reaction that had entrapped the right ureter was also noted. Another nylon cable tie was removed and the ureter was released. Eight months postoperatively, the dog was in good general physical condition, showing appetite and vigour. Abdominal ultrasonography showed improvement of the hydronephrosis in both kidneys. The urea ratio was normal, but the creatinine level was slightly elevated, suggesting a guarded prognosis. Thus, bilateral hydronephrosis as observed in the present study should be considered as a major complication after elective ovariohysterectomy.

A rare late post-cast­ration complication in a bitch – a case report

“…In our patient, no other postcastration complication were established. Inadequate operative technique, improper placement of ligatures during ovariohysterectomy and formation of granulomas could result in compression or ligation of ureters and consequently, in hydronephrosis (Mesquita et al, 2015). In our case, although the granuloma was located caudally to the left kidney and close to the ureter, no signs of hydronephrosis were observed.…”

“…Intraoperative and early post-operative complications are bleeding of different origin (Pearson, 1973), trauma of organs, torn stitches and organ prolapse (Blacklock et al, 2016), peritonitis (Dorn, 1977). Later complications comprise stump or uterine pyometra (when only ovaries have been removed), formation of granulomas or abscesses around nonabsorbable ligatures, hydronephrosis after accidental ligation of ureters (Mesquita et al, 2015), pyelonephritis, formation of rectovaginal, cytovaginal, vaginoperitoneal and abdominal fistulas (Gadelha et al, 2004;Holt et al 2006;Johnson-Neitman et al, 2006), ovarian remnant syndrome (Wallace, 1991;Ball et al, 2010) etc. All these complications are most commonly caused by poor asepsis and antisepsis, improper operative technique and period for castration, improper suture material and inadequate post-operative care.…”

“…The formation of granulomas in this region has been described as post-castration complication of occurrence of nylon or other nonabsorbable ligatures (Johnson-Neitman et al, 2006;Mesquita et al, 2015), as well as consequently to compromised surgical asepsis (Kelly et al, 2016). In our case, no information was available on the nature of material used to ligate the ovarian blood vessels, but there were remnants of a multifilament thread, possibly nonabsorbable.…”

Femoral Diaphyseal Fractures Fixation Technique Using an Adjustable Nylon Tie in Dog (Canis lupus familiaris) and Cat (Felis catus domesticus)

“…Nevertheless, adjustable nylon ties polyamide 6.6 was already used in different surgical procedures [7,31], including orthopedic surgeries, applied to human [22,28]. Complications reported in the literature [4,18,20,32] due to the use of polyamide nylon ties were associated with erroneous surgical techniques. Their use in surgeries procedures must follow the correct surgical technique and they have to be sterilized in the autoclave before their use; tensile strength losses were not recorded after sterilization [19,21,25].…”

Complicações tardias do uso de abraçadeiras de náilon para ligadura de pedículos ovarianos em cadela: relato de caso

“…Os sinais clínicos podem surgir num período que varia de poucos meses a anos após a realização da cirurgia (Macedo et al 2012;Mesquita et al 2015), e varia de acordo com a área cometida. A paciente do caso relatado apresentava vômito recorrente e perda de peso progressiva, pois o estômago e parte do intestino da cadela estavam aderidos ao granuloma.…”