Marsupialization of Umbilical Vein Abscesses With Involvement of the Liver in 13 Calves

Abstract

Omphalophlebitis with liver involvement was diagnosed by ultrasonography in 13 calves. In the initial surgical procedure, the infected umbilical vein was marsupialized by cranial translocation in a median celiotomy and was flushed daily until healing occurred. In a second surgical procedure, the contracted umbilical vein was removed. Nine calves were clinically healthy after treatment. One had reformation of two abscesses because of inadequate post-surgical treatment. One calf was euthanatized because of an intussusception of the small intestine, and two calves had adverse reactions and developed septic shock when some of the lavage fluid, which was applied under pressure, entered the systemic circulation. It was concluded that umbilical vein abscesses should not be flushed under pressure in calves younger than 2 months of age. The principal advantages of cranial translocation of the umbilical vein in a median celiotomy are that only one abdominal incision is required and that the infected umbilical vein tissue does not have to be passed intraabdominally to a paramedian position.

Medical and surgical management of an intra-abdominal abscess of hepatic origin in a horse

“…Intra-abdominal abscesses, in particular larger lesions or those characterized as having thick walls, have been well documented in large animals as necessitating surgical removal or drainage, whereas antimicrobial treatment alone is often insufficient to resolve the disease. 23,34 The large volume of necrotic hepatic parenchyma and the thickwalled abscess capsule may have contributed to the decreased antimicrobial efficacy and need for surgical intervention in the horse of the present report.…”

Urogenital Surgery in Camelids

“…Frequently establishing ventral drainage is all that is needed to allow the infection of the vein to resolve. 50 Owners should be informed that a second surgery may be required after the infection has resolved to resect the vein and close the defect in the body wall. This is most commonly required after marsupialization at the cranial extent of the ventral midline incision.…”

“…When this occurs, umbilical vein marsupialization is indicated. 49,50 Marsupialization of the vein may be done at the cranial end of the skin incision or through a separate body wall incision cranial to the right of the skin incision. Marsupialization through a separate stab incision is preferred because of fewer incisional complications.…”

“…When an abscess of an umbilical remnant caudal or cranial to the mass is suspected, it is reasonable to make the initial body wall incision opposite the suspected abscess. 49,50 Then the clinician should dissect around the hernia sac or mass with an elliptical body wall incision while using fingers or instruments to retract associated structures out of harm's way. The body wall incision may then be continued cranially or caudally, as needed, because of abscess or involvement of fetal remnants.…”

Avaliação ultrassonográfica de componentes umbilicais inflamados em bezerros da raça Holandesa com até 30 dias de vida

“…Para a obtenção de tais informações, são rotineiramente utilizados recursos semiológicos como o exame físico, com inclusão de cuidadosa palpação bimanual da região umbilical e abdominal, além de exames laboratoriais complementares, os quais demonstram limitações na identificação de alterações intra-abdominais, tanto nos componentes umbilicais propriamente ditos, como nos ór-gãos decorrentes das infecções ascendentes, como o fígado e bexiga. Tal fato leva o médico veterinário a lançar mão de outros métodos diagnósticos, como exame por imagens e laparotomia exploratória (Steiner et al 1992, Figueirêdo 1999, Dirksen 2005. Por serem menos invasivos os recursos diagnósticos por imagem disponíveis, elegeu-se para tal finalidade a realização do exame ultrassonográfico pela praticidade e acessibilidade nas condições à campo (Behn et al 2000), além de ser mais sensível para a verificação de acometimentos de estruturas umbilicais intra-abdominais em comparação com a palpação (Reef et al 1989, Lischer & Steiner 1994, Flöck 2002, Steiner & Lejeune 2009).…”