Tube cystostomy for management of uroperitoneum (water belly) in a weaned Brahma bull-calf

M. Munif, M. Safawat, Abdul Hannan
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Abstract

Objective: This study highlights a case of uroperitoneum from urinary bladder rupture in a bovine calf and further describes the surgical interventions. Materials and Methods: A 7-month-old weaned Brahma bull-calf was presented with a distended abdomen alongside a history of complete absence of urination for 9 days. Previously, the animal suffered from urinary inconsistence and dribbling-type urination. Physical palpation on the ventral aspect of the distended abdomen revealed a fluid-filled condition, and further needle aspiration confirmed the fluid to have a slightly alkaline pH resembling that of urine. The preputial manipulation and urinary catheterization were of no use for the obstruction. A light uremic smell was found in the animal’s breathing. Elevated blood urea nitrogen and creatinine were also detected. Clinically, it was assumed to be a ruptured urinary bladder (cystorrhexis) and subsequently diagnosed as a case of uroperitoneum (water belly). Paramedian laparotomic exploration was carried out to detect the ruptured part (perforation) of the bladder, and simultaneous expulsion of the accumulated peritoneal urine was done. A tube cystostomy was performed with Foley’s catheter to handle the case after repairing the perforated bladder (cystorrhaphy). In the postoperative phase, supportive medications and good management were ensured. Results: The calf recovered within 2 weeks of surgery and was found to maintain unremitting urine flow through the surgically fixed catheter. However, the calf was culled after 1 month of surgery. Conclusions: Tube cystostomy can be an effective approach for the management of water bellies in calves to save lives.
管式膀胱造口术治疗断乳布拉马犊牛的尿腹膜(腹水)
目的:本研究报告一例牛犊牛膀胱破裂致尿腹膜,并进一步描述手术治疗。材料和方法:一只7个月大的断奶婆罗门公牛犊牛出现腹部肿胀,并有9天完全没有排尿的历史。此前,这只动物患有尿不一致和滴水型排尿。物理触诊膨胀腹部腹侧显示充满液体,进一步针吸证实液体具有与尿液相似的微碱性pH值。包皮操作和导尿对梗阻无效。在这只动物的呼吸中发现了轻微的尿毒症气味。血尿素氮和肌酐升高。临床上假定为膀胱破裂(膀胱炎),随后诊断为尿腹膜(腹水)。腹腔镜探查膀胱破裂部位(穿孔),同时排出腹膜积尿。在膀胱穿孔(膀胱成形术)修复后,采用Foley导尿管行膀胱管造瘘术。术后给予支持性药物治疗和良好的管理。结果:小腿术后2周内恢复,经手术固定尿管后尿流通畅。然而,小牛在手术1个月后被宰杀。结论:管式膀胱造瘘是处理小牛腹水的有效方法,可挽救生命。
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