加拿大奶牛肉牛皱胃移位

1、皱胃移位Abomasal DisplacementPrepared by: Dr. Terry Hunt Translated by Dr. Fu Xiaoping病因/发病机理 Cause & Pathogenesis由于皱胃下划至瘤胃下方，卡在体壁和瘤胃间，降低瘤胃充盈度Decreased rumen fill allowing abomasum to slip under rumen and be trapped between body wall and rumen左侧移位高于右侧移位Left Displacement more common then Right Displaceme

2、nt仅在产犊后常见Seen most commonly just after calving危险因素Risk Factors精料过多-颗粒料High concentrate feeding particle size低纤维日粮Low fibre diets with lush pasture产犊Calving并发病-内毒血症，低钙症Concurrent diseases endotoxemia, hypocalcemia缺乏运动Lack of exercise临床症状Clinical Findings左侧移Left (LDA) 泌乳早期Early lactation食欲下降Decreased

3、appetite除非有并发症，可视症状正常Normal vital signs unless concurrent disease排粪稀少Scant feces瘤胃蠕动音减少，音质似来自远方Decreased rumen sounds and may sound distant左侧听到叮当拍水音Tinkling splashing sounds on left side在左侧腹腰部（坎部下方）怀疑皱胃移位处听到金属音Ping (metallic) in defined area of left para-lumbar fossa右侧移位Right (RDA)症状类似左侧移位，牛病情更重Simi

4、lar signs to LDA but cow will be more ill在右侧坎部下方可听到溅水音和金属音Ping and splashing sounds in right para-lumbar fossa直肠触诊皱胃扩张（右侧） May palpate distended abomasum rectally (right side)渐进性扩张，将导致扭转Dilation is progressive and will progress to Volvulus (torsion)诊断Diagnosis临床症状和金属音（直肠检查前进行核查）Clinical signs and pr

5、esence of Ping (check before a rectal exam)鉴别诊断Differential Diagnosis左侧 Left单纯性消化不良 Simple indigestion酮病 Ketosis创伤性疾病 Hardware右侧 Right盲肠扩张/扭转 Cecal dilatation/Volvulus皱胃溃疡 Abomasal ulcer 肠梗阻 Intestinal obstruction/accident实验室和病理学诊断Laboratory and Pathology代谢性碱中毒Metabolic alkalosis (HCl in abomasum)酮尿

6、ketonuria治疗Treatment左侧非手术治疗Left non-surgical将牛右侧扳倒Caste cow onto right side来回摇摆 Roll onto back (shake back & forth)扳回左侧，然后让牛站立Roll onto left side and allow to stand左腹手术Left Surgical盲针缝合皱胃手术-套索针固定法 Blind stitch abomasopexy - Toggle fixation右侧卧倒Caste onto right side扳回左侧Roll onto back检查套索针及线Check for p

7、ing and toggle (two)胸骨后10厘米，中线10厘米10 cm behind sternum, 10 cm to right of midline右腹网膜手术-牛站立Right flank omentopexy standing cow右侧剖腹手术Right side celiotomy用针、导管等对皱胃减压Decompress abomasum with needle, tube and vacuum右侧重新定位，将切口缝合到网膜（从幽门开始8厘米）Relocate to right side and suture omentum (8 cm from pylorus) in

8、to incision site用单纯性连续缝合方式缝合各层Close individuals layers with simple continuous pattern右腹正中旁固定术-奶牛仰卧Right paramedian abomasopexy dorsal recumbency胸骨后面切口10厘米，中线右侧10厘米Incision 10 cm behind sternum, 10 cm to right of midline纠正皱胃Relocate abomasum & ID greater curvature找到网胃皱胃韧带，缝合15厘米ID reticulabomasal lig

9、ament and begin suture 15 cm caudal to it胃缝合到腹膜上&内纵肌外膜Suture abomasum (not full thickness) into peritoneum & internal rectus sheath缝合肌肉层Close muscle layer用可吸收线不连续性缝合外横肌外膜Close external rectus sheath with absorbable simple interrupted pattern缝合皮肤Close skin右侧移位/扭转Right Displacement/Volvulus手术Surgery (

10、never roll) 右侧开刀术Right-sided celiotomy网膜缝合Omentopexy皱胃可能需减压或排尿/粪May require decompressing or draining可能需要纠正扭转（多数是顺时针方向） May require untwisting (most are counter clockwise)预后情况Prognosis左侧移位预后良好 Good for LDA伴有扭转时，预后情况不良 With Volvulus, prognosis is guarded to poor预防Prevention & Control限制干奶期精料的摄入 Restrict conce