Duodenal ileus caused by a calf feeding nipple in a cow

Abstract

BackgroundThe aim of this report was to describe duodenal obstruction caused by a rubber foreign body in a cow.Case PresentationThe clinical, biochemical and ultrasonographic findings in a five-year-old Swiss Braunvieh cow with duodenal ileus caused by a calf feeding nipple are described. The main clinical signs were anorexia, ruminal tympany, decreased faecal output and abomasal reflux syndrome. Ultrasonographic examination revealed reticular hyperactivity and a dilated duodenum. A diagnosis of duodenal ileus was made and the cow underwent right-flank laparotomy, which revealed a dilation of the cranial part of the duodenum because of obstruction by a pliable foreign body. This was identified via enterotomy as a calf feeding nipple. The cow was healthy at the time of discharge four days after surgery and went on to complete a successful lactation.ConclusionsTo our knowledge, this is the first description of duodenal obstruction by a calf feeding nipple. This is an interesting case, which broadens the spectrum of the causes of duodenal ileus, which is usually caused by obstruction of the duodenum by a phytobezoar.

Intestinal Surgery

“…Phytobezoar or trichobezoar, and foreign bodies, were reported to cause intraluminal obstruction, whereas adhesions and liver abscesses may cause extraluminal obstruction. [9][10][11][12][13][14][15] Strangulation of the caudal flexure of the duodenum was reported in 3 cows during late pregnancy because the uterus had passed through a rent in the mesoduodenum. 16,17 A duodenal obstruction caused by a malposition of the gallbladder was also reported.…”

Duodenoduodenostomy for obstruction of the sigmoid flexure of the duodenum in cattle

“…1,2 Cattle with duodenal obstruction are often excellent milk producers and show progressive clinical signs of anorexia, decreased fecal output, and abomasal reflux syndrome. 3 Clinical signs Results of this report were presented in part at the American College of Veterinary Surgeons Surgery Summit, October 24-26, 2013, San Antonio, Texas. and biochemical findings, including depression, hypovolemia, and hypochloremia, are consistently present in cattle with duodenal obstruction.…”

“…Obstruction of the sigmoid flexure of the duodenum adjacent to the liver has been described infrequently in cattle . Cattle with duodenal obstruction are often excellent milk producers and show progressive clinical signs of anorexia, decreased fecal output, and abomasal reflux syndrome . Clinical signs and biochemical findings, including depression, hypovolemia, and hypochloremia, are consistently present in cattle with duodenal obstruction.…”

“…Conditions associated with duodenal compression in cattle include volvulus of the sigmoid flexure of the duodenum, malposition of the gallbladder, entrapment by the uterus or round ligament of the liver, postoperative complications following omentopexy/pyloropexy and duodenal surgery, adjacent abscessation or lymphosarcoma, omental and mural adhesions, or stricture . Luminal blockage of the duodenum in cattle can result from coagulated intestinal hemorrhage, bezoars, or ingested foreign bodies, such as gravel or calf feeding nipples . Immediate surgery is indicated to identify the source of obstruction and reestablish intestinal patency .…”

“…2,[4][5][6][7][8][9][10] Luminal blockage of the duodenum in cattle can result from coagulated intestinal hemorrhage, bezoars, or ingested foreign bodies, such as gravel or calf feeding nipples. 2,3,[9][10][11][12] Immediate surgery is indicated to identify the source of obstruction and reestablish intestinal patency. 2 An early description of surgical correction of functional stenosis of the sigmoid flexure of the duodenum was reported in 15 cattle, in which duodenoduodenostomy maintained abomasal outflow and resulted in excellent survival outcomes compared with medical management.…”