Ch 86 Peritoneum and Retroperitoneum Flashcards
Griffeuille JAVMA 2021
Comparison of computed tomography and surgical findings
and investigation of their associations
with outcomes for dogs with sublumbar abscesses
RESULTS
51 dogs met the study inclusion criteria; 48 were included in outcome
analysis. The CT findings agreed with surgical findings for identification of
a migrating vegetal foreign body for 39 of 51 (77%) dogs. All dogs survived
to hospital discharge; 1 dog died of hemoabdomen 3 days after surgery,
and 6 had minor (surgical wound) complications reported. Abscess recurrence
developed in 12 of 48 (25%) dogs with a median time to recurrence
of 6 months. Identification of diskospondylitis on CT examination was the
only investigated factor significantly associated with recurrence; odds of
recurrence in dogs with this finding were 8.4 times those for dogs without
this finding.
CONCLUSIONS AND CLINICAL RELEVANCE
Our results suggested dogs with sublumbar abscesses have a good prognosis
after surgery, although recurrence can develop. Preoperative identification
of diskospondylitis was significantly associated with abscess recurrence
in this study sample.
Anderson JSAP 2021
Outcome following surgery to treat
septic peritonitis in 95 cats in the
United Kingdom
Results: Ninety-five cats were included. The overall survival rate was 66%. Lethargy (89%) and anorexia
(75%) were the most common clinical signs, with abdominal pain and vomiting in 44% and 27%
of cases, respectively. Gastro-intestinal leakage was the most common source of contamination. The
presence of an abdominal mass on clinical examination was not strongly predictive of the presence of
neoplasia on histology and did not confer a worse prognosis. Cats presenting with dehiscence of a previous
enterotomy/enterectomy did not have a worse prognosis than those presenting with other aetologies.
Intraoperative hypotension (adjusted odds ratio 0.173, 95% confidence intervals 0.034 to 0.866,
P=0.033) was associated with non-survival. Cats that survived beyond 1 day postoperatively had an improved
likelihood of survival (87.5%). All cats that survived beyond 6 days were successfully discharged.
Clinical Significance: This study describes the largest group of cats with septic peritonitis with an overall
survival rate of 66%. The presence of an abdominal mass on clinical examination or having dehiscence
of a previous gastrointestinal surgery did not confer a worse prognosis.
Jacques JSAP 2022
Clinical, computed tomographic, surgical findings and outcome in dogs with sublumbar abscessation: 16 cases (2013-2019)
R
esults: Sixteen dogs were included in this study with a median follow-up period of 36 months (15/16). Clinicals signs included flank or lumbar soft tissue swelling (12/16), lumbar pain (11/16), hyperthermia (8/16), a cutaneous discharging sinus (5/16) and lethargy (5/16). CT findings were: abscesses of varying size localised in the psoas muscles (16/16), spondylitis (12/16), vertebral osteomyelitis (6/16), discospondylitis (2/16) and epidural inflammation (8/16). Thoracic lesions were present in eight of 12 dogs. Exploratory surgery was performed in 16 dogs via a midline celiotomy in 15 of 16 and a lateral approach in one of 16 cases. The surgical approach was selected based on the location of the draining tracts detected on CT imaging. Vertebral body curettage was performed in five of 16 cases with lesions identified on CT. Vegetal foreign material was found in seven of 16 dogs. Of the 15 animals with long-term follow-up, 13 had no signs of recurrence.
C
linical Significance: Surgical treatment of sublumbar abscessation resulted in a good long-term outcome when CT was used to guide the surgical approach and to plan the procedure. Our study highlights common vertebral and epidural lesions associated with sublumbar abscesses with a prevalence of 87.5%.
Culp JAVMA 2021
Use of percutaneous microwave ablation in the treatment
of retroperitoneal neoplasia in three dogs
CLINICAL FINDINGS
Dogs between 11 and 13 years of age weighing between 13.7 and 43.8 kg
had either a renal mass (n = 2) or a mass located in the caudodorsal aspect
of the retroperitoneal space near the right side of the diaphragm (1). Cytology
revealed that one of the renal masses and the mass located near the
diaphragm were malignant neoplasias. Findings on cytologic evaluation of a
sample of the other renal mass was nondiagnostic. Maximum mass diameters
ranged between 1.4 and 2.5 cm.
TREATMENT AND OUTCOME
All dogs were treated by percutaneous MWA. Probes were directed into
tumors by use of ultrasound and CT guidance, and microwave energy was
applied to each mass. Findings on imaging of each mass following MWA
was consistent with successful treatment. No intraprocedural or major
postprocedural complications occurred, and all dogs were discharged
from the hospital within 3 days of treatment. Two dogs died at 3 and 21
months after MWA with no known local recurrence; 1 dog was still alive
64 months after treatment.
CLINICAL RELEVANCE
Although the indications for MWA in the treatment of neoplasia in companion
animals are limited, the outcomes of dogs in the present report provided
preliminary evidence that percutaneous MWA can be safely used to
effectively treat retroperitoneal neoplasia. This procedure was successfully
performed with image guidance in all 3 dogs.
Lopez Vet Surg 2020
Effect of subcutaneous closure technique on incisional
complications and postoperative pain in cats undergoing midline
celiotomy: A randomized, blinded, controlled trial
Methods: Cats (n = 297) were assigned to one of three subcutaneous
closure methods: simple continuous apposition with tacking to the rectus
fascia (n = 108, quilting [Q] group); simple continuous apposition (SC;
n = 94); no subcutaneous closure (NC; n = 95). Primary outcomes were
incidence of seroma formation, postoperative pain, and surgical site infection
or dehiscence. Active follow-up was obtained at 10 and 30 days
postoperatively.
Results: Baseline characteristics did not differ between groups. Seroma was less
common in the Q group (13.0%) than in the NC (27.3%) and SC (25.9%) groups
(P = .03). Compared with the other two groups, the relative risk of seroma formation
in the Q group was 0.49 (95% CI = 0.28-0.86, P = .01). Median mechanical
pain thresholds were higher (indicating greater comfort) in cats with subcutaneous
sutures (Q and SC = 1.23 [interquartile range (IQR), 0.2-2.6 N], NC = 0.83 [IQR,
0-1.87 N], P = .04) on the day after surgery.
Conclusion: Closing subcutaneous tissues with a quilting closure pattern reduced
seroma formation in cats undergoing celiotomy.
Clinical significance: Placing a quilting suture pattern in the subcutaneous tissues
after celiotomy is a simple low-cost measure that reduces seromas in cats.
Abstaining from subcutaneous closure cannot be recommended because of
increased seroma formation and pain.
Gomez Martin JAVMA 2023
Computed tomography and magnetic resonance
imaging are potential noninvasive methods
for evaluating the cisterna chyli in cats
METHODS
The presence, location, shape, maximum width, MRI-signal intensity, mean attenuation, and contrast enhancement of the CC were recorded from CT and MRI scans.
RESULTS
The CC was identified in all the CT scans and in 60 MRI studies. The CC was located level with the cranial mesenteric artery in 56 of 91 cases. It was crescent shaped in 34 of 54 cases. On precontrast CT images, the mean attenuation of the CC was 17 HU, and the mean postcontrast attenuation was 28 HU. On T2-weighted sequences, the CC was isointense to CSF and hyperintense to the muscles, while on T1-weighted images, it was isointense to the muscles. Contrast enhancement was variable in both techniques.
CLINICAL RELEVANCE
CT and MRI have the potential for noninvasive evaluation of CC in cats.
Walter JaVMA 2023
Treatment of retroperitoneal sarcoma results
in improved outcomes
RESULTS
Hemangiosarcoma was the most common histologic subtype diagnosed (76.1%). Cytoreductive and curative intent surgical excision of the RPS was attempted in 12 and 22 dogs, respectively; 12 dogs underwent no surgery or had an exploratory laparotomy with incisional biopsy only. Nineteen dogs received adjuvant chemotherapy, either injectable or metronomic, and 1 dog received adjuvant radiation therapy. Fourteen of the 34 (41.2%) surgically treated dogs developed evidence of local recurrence, but there was no difference in local recurrence when comparing dogs categorized as curative intent versus cytoreductive surgery. The median overall survival time was 238 days. On multivariable analysis, treatment approach was associated with survival with surgical excision (vs palliative treatment) and adjuvant chemotherapy following surgery being protective against death. A diagnosis of hemangiosarcoma was associated with a greater hazard of death.
CLINICAL RELEVANCE
This study demonstrates a substantially greater survival time than previously published and suggests a survival benefit from surgical excision and adjuvant chemotherapy
