一例犬肺炎克雷伯菌感染引发幽门管狭窄的诊断及手术治疗

Diagnosis and surgical treatment of a case of canine pyloric canal stenosis caused by Klebsiella pneumoniae infection

1只6岁的雄性松狮犬,食欲不振,反复呕吐大量黄色黏液,发热。经多次治疗效果不佳,就诊前近半个月症状加重。笔者对该病例进行血常规、血清生化指标、B型超声波和细菌学等检查,结合临床症状进行综合诊治。结果表明:患犬确诊为肺炎克雷伯菌感染引发幽门管狭窄。首次治疗采取切除幽门管及肿物并施行十二指肠与胃幽门窦末端的端-端吻合术,但术后并发吻合口阻塞不通;二次手术施行空肠近端与胃幽门窦区的侧-侧吻合术,并结合药敏试验结果进行抗菌治疗。术后患犬恢复良好,且术后16个月回访未见消化异常。说明空肠与胃幽门窦侧-侧吻合术对消化系统的功能没有明显不良影响,对幽门管狭窄具有良好的治疗效果。

A 6-year-old male chow had the symptoms of loss of appetite,repeated vomiting of large amounts of yellow mucus and fever.After repeated treatment,the effect was not good,and the symptoms worsened nearly half a month before seeing the doctor.In order to make diagnosis and treatment of the case,the examinations such as blood routine examination,serum biochemical examination,B-mode ultrasound examination and bacteriological examination were carried out;and comprehensive diagnosis and treatment were carried out in combination with clinical symptoms.The results showed that the dog was diagnosed as pyloric canal stenosis caused by Klebsiella pneumoniae infection.At the first treatment,the pyloric canal and goitre were removed and end-to-end anastomosis of the duodenum and gastric end of pyloric antrus was performed,but the postoperative anastomosis was complicated with obstruction.The second operation performed side-to-side anastomosis of the proximal jejunum and gastric pyloric antrum,and the antibacterial treatment was performed combined with the results of drug sensitivity test.The dog recovered well after the operation,and there was no digestive abnormality in the follow-up visit of 16 months after the surgery.The results suggested that the side-to-side anastomosis of jejunum and gastric pyloric sinus had no obvious adverse effect on the function of digestive system and had a good therapeutic effect on the disease.