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Four Methods of Surgical Correction of Abomasal Displacement in the Cow Jim Connell Iowa State University

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Four Methods of Surgical Correction of Abomasal Displacement in the Cow Jim Connell Iowa State University Volume 38 | Issue 1 Article 7 1976 Four Methods of Surgical Correction of Abomasal Displacement in the Cow Jim Connell Iowa State University Follow this and additional works at: https://lib.dr.iastate.edu/iowastate_veterinarian Part of the Gastroenterology Commons, Large or Food Animal and Equine Medicine Commons, and the Surgery Commons Recommended Citation Connell, Jim (1976) "Four Methods of Surgical Correction of Abomasal Displacement in the Cow," Iowa State University Veterinarian: Vol. 38 : Iss. 1 , Article 7. Available at: https://lib.dr.iastate.edu/iowastate_veterinarian/vol38/iss1/7 This Article is brought to you for free and open access by the Journals at Iowa State University Digital Repository. It has been accepted for inclusion in Iowa State University Veterinarian by an authorized editor of Iowa State University Digital Repository. For more information, please contact [email protected]. Four Methods of Surgical Correction of Abomasal Displacement in the Cow by Jim Connell* The purpose of this paper is to compare paralumbar fossa is clipped and surgically and contrast various surgical methods of scrubbed. Either a paralumbar nerve block correction of displaced abomasum in cattle. or inverted "L" block is placed with 2% Points to be considered include: The lidocaine to anesthetize the site of the relative ease of the procedure; the exposure incision. A 20 cm skin incision is made afforded if complications arise; and, of vertically in the center of the paralumbar course, the chances of success. fossa. The external and internal oblique . The abomasum normally lies slightly to muscles are incised as they are encountered the right of the midline on the floor of the as is the transversus abdominis. The abdominal cavity extending fr,om the peritoneum is carefully incised so as not to xiphoid to the ninth or tenth rib with the cut any underlying structures. At this point body between the ventral sac of the rumen the surgeon inserts his arm and passes and the omasum. The superficial part of the posterior to the intestinal mass and the greater omentum is attached to the greater rumen to the left abdominal wall where he curvature of the abomasum and to the should be able to palpate the gas-filled transverse duodenum.10 When the abomasum. Then using a large bore needle abomasum is displaced to the left it is and rubber tubing the abomasum is usually found in or just anterior to the left deflated to expidite return to the right side. paralumbar fossa between the rumen and The abomasum is sw:~pt ventral to the the body wall. In a displacement the greater rumen by the surgeons hand and forearm omentum is stretched ventral to the rumen until it can no longer be detected on the since it also attaches to the duodenum. The left. At this point the duodenum is located proximal portion of the abomasum near the in the superficial layer of the greater omaso-abomasal orifice will be stretched omentum. It should be running tran­ and could be torsed. sversely across the area of the incision. The object of any surgery to correct a Trace it anteriorly to the pylorus to verify displaced abomasum is to return it to a the presence of abomasum on the right normal postition. It is also important to side. A fold of this omentum is then at­ stabilize it in that position to prevent tached to the edge of the incision with a recurrence of the problem. At the present staple suture of #3 gut. The omentum is time there are four methods of correction included in the first layer of the standard that are used regularly by veterinarians: three layer laparotomy closure thereby left paralumbar a bomasopexy, right establishing an omentopexy to stalilize the paralumbar omentopexy, right ventral abomasum. 3,4 abomasopexy and closed suture This operation can be done by one man abomasopexy. working alone and can be done in a short To prepare for the right paralumbar period of time. If adhesions are present omentopexy3,4,a the cow is restrained in a they must be broken down blindly hoping head-gate or stocks and given tranquilizers not to perforate the abomasum. If there is a as is seen fit by the surgeon. The perforating ulcer or a rent is made in the abomasum a left flank laparotomy is in­ dicated to attain exposure to effect repairs *J. Connell is a fourth year student in the College of on the abomasum. There is also a chance of Veterinary Medicine, Iowa State University. peritoneal contamination when the needle Issue No.1) 1976 21 is removed from the abomasum. Also, a a possibility of regurgitation and aspiration friable abomasum could easily tear in the of rumen content. This is a factor that must process of replacement. Gabel at Ohio State be considered as a risk when contemplating University claimed 86% success in 147 the surgery. cases operated in this manner.3 This is by A publication of this surgery from Cornell far the greatest number operated on in any University revealed 94% success in 82 published study of the right approach. cases? A good adhesion would be directly Recurrence was seen in fewer than 3% of formed between the abomasum and ventral the cases and involved an elongation of the abdominal wall thereby permanently omentum attached to the abdominal wall. establishing the abomasum in its corrcet Correction of a displaced abomasum via position. the right ventral abomasopexy7,a,9,12 Abomasopexy of the displaced requires that the animal be restrained on its abomasum can also be done from the left back with the fore and hind limbs stretched side by using a left paralumbar out. A tranquilizer is usually needed to laparotomy.S,a,ll In preparation for place the cow in this position. The surgical surgery the animal is clipped in the area of site is just posterior to, and to the right of the left paralumbar fossa. Another spot is the xiphoid, midway between the ventral also clipped and prepared for surgery just midline and the milk vein. The area is to the right of the ventral midline and clipped and scrubbed as is standard for posterior to the xiphoid area. A paralumbar surgery and a line block is placed with 2 % or field block is placed to anesthetize the lidocaine along the incision line. The in­ operative site in the paralumbar fossa. A 20 cision extends about 20 cm from just em vertical skin incision is made 5-6 cm posterior to xiphoid. The aponeurosis of the posterior to the last rib. The external external oblique is encountered and cut as oblique, internal oblique, transversus is the rectus abdominis muscle. Then the abdominis and peritoneum are each cut in transversus abdominis and peritoneum are turn as they are encountered. The carefully incised. The surgeon can now abomasum should be readily visible in the insert his arm into the abdominal cavity and incision or just anterior to it. Approximately reaching across the midline can palpate and two meters of heavy Vetafil is double armed retrieve the gas-filled abomasum. At this with straight cutting needles. The Vetafil is point decompression may rarely be passed through the muscle 6f the necessary to return the abomasum to a abomasum in a continuous in and out more normal position. Once the abomasum pattern over the greater curvature, being is in place, an abomasopexy is performed careful to avoid the omental attachments. by suturing the abomasum to the lateral With the needles held in the surgeons margin of the incision using simple in­ hand in a protective manner the surgeon terrupted or mattress sutures with .#3 gut. passes his hand along the abdominal wall Then the abomasal musculature is closed in ventral to the rumen and across the the first layer of the incision with the midline. Here he palpates with his finger peritoneum and transversus abdominis. until an assistant directs him to the The rectus, abdominal tunic and skin are all prepared site to the right of the midline. closed separately. One needle is pushed through the ventral This technique will cause two lines of abdominal wall and the second is placed 10­ adhesions of the abomasum to the right 15 em posterior. Then with hand and abdominal wall. We again are faced with forearm the surgeon forces the abomasum the possibility of tearing the abomasal wall ventrally until it is in contact with the body through blindly breaking down the wall while the assistant gently takes up the adhesions. In such a case the abomasum slack in the ventral suture. The suture is can be and should be inspected for ulcers tied on the outside by the assistant when that are nearing perforation. This surgery the surgeon has determined there are no can be done by one man, however, a structures between the abomasum and the minimum of three would have to be present body wall. The gas in the abomasum to adequately position the animal. With the generally passes off as it is manipulated animal tranquilized and on its back there is back into normal position. The laparotomy 22 Iowa State University Veterinarian incision is closed using a three layer sutures can be pulled too tight causing a technique. tearing of the abomasum. This is a valid The best exposure of the abomasum is technique that allows an economic break to probably gained using this technique. The the owner and a good chance of success. abomasum is readily inspected and repaired at the site of incision. The suture SUMMARY should be placed immediately in the abomasum so that through excessive Any of the procedures described in this manipulation it does not lose gas and slip paper can be done in a short time by a away.
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