Ultraschallbefunde und Therapie bei einer Kuh mit einem Hämangiosarkom in der Harnblase

A 4.5-year-old Swiss Braunvieh cow was presented to the Department of Farm Animals, University of Zurich, because of severe haematuria. All other clinical findings were within normal ranges. Transrectal ultrasonography revealed a 1 cm × 1 cm echogenic, irregularly-shaped, raised mass in the wall of the urinary bladder. Endoscopy identified the mass as a proliferation, approximately 0.5 cm in diameter, which was bleeding continuously. Thermocautery of the bleeding site was carried out twice five days apart via endoscopy. Clinical signs resolved for the remainder of the cow’s life; she was slaughtered 15 months later because of infertility. Histological examination of the mass revealed a haemangiosarcoma

Perineal stapled prolapse resection for external rectal prolapse: is it worthwhile in the long-term?

Background: Perineal stapled prolapse (PSP) resection is a novel operation for treating external rectal prolapse. However, no long-term results have been reported in the literature. This study analyses the long-term recurrence rate, functional outcome, and morbidity associated with PSP resection. Methods: Nine consecutive patients undergoing PSP resection between 2007 and 2011 were prospectively followed. Surgery was performed by the same surgeons in a standardised technique. Recurrence rate, functional outcome, and complication grade were prospectively assessed. Results: All 9 patients undergoing PSP resection were investigated. The median age was 72years (range 25-88years). No intraoperative complications occurred. Faecal incontinence, preoperatively present in 2 patients, worsened postoperatively in one patient (Vaizey 18-22). One patient developed new-onset faecal incontinence (Vaizey 18). The median obstructive defecation syndrome score decreased postoperatively significantly from 11 (median; range 8-13) to 5 (median; range 4-8) (p<0.005). At a median follow-up of 40months (range 14-58months), the prolapse recurrence rate was 44% (4/9 patients). Conclusions: The PSP resection is a fast and safe procedure associated with low morbidity. However, the poor long-term functional outcome and the recurrence rate of 44% warrant a cautious patient selectio

Outcomes of elective liver surgery worldwide: a global, prospective, multicenter, cross-sectional study

Background: The outcomes of liver surgery worldwide remain unknown. The true population-based outcomes are likely different to those vastly reported that reflect the activity of highly specialized academic centers. The aim of this study was to measure the true worldwide practice of liver surgery and associated outcomes by recruiting from centers across the globe. The geographic distribution of liver surgery activity and complexity was also evaluated to further understand variations in outcomes. Methods: LiverGroup.org was an international, prospective, multicenter, cross-sectional study following the Global Surgery Collaborative Snapshot Research approach with a 3-month prospective, consecutive patient enrollment within January–December 2019. Each patient was followed up for 90 days postoperatively. All patients undergoing liver surgery at their respective centers were eligible for study inclusion. Basic demographics, patient and operation characteristics were collected. Morbidity was recorded according to the Clavien–Dindo Classification of Surgical Complications. Country-based and hospital-based data were collected, including the Human Development Index (HDI). (NCT03768141). Results: A total of 2159 patients were included from six continents. Surgery was performed for cancer in 1785 (83%) patients. Of all patients, 912 (42%) experienced a postoperative complication of any severity, while the major complication rate was 16% (341/2159). The overall 90-day mortality rate after liver surgery was 3.8% (82/2,159). The overall failure to rescue rate was 11% (82/ 722) ranging from 5 to 35% among the higher and lower HDI groups, respectively. Conclusions: This is the first to our knowledge global surgery study specifically designed and conducted for specialized liver surgery. The authors identified failure to rescue as a significant potentially modifiable factor for mortality after liver surgery, mostly related to lower Human Development Index countries. Members of the LiverGroup.org network could now work together to develop quality improvement collaboratives

Nachhandparese infolge eines malignen Lymphoms bei einer Ziege

Zusammenfassung:In der vorliegenden Arbeit wird ein Fall von Nachhandparese bei einer 4 Jahre alten Ziege durch ein malignes Lymphom beschrieben. Die Ziege wurde wegen einer progredienten Ataxie der Nachhand, welche schliesslich zur Nachhandparese und zum Festliegen geführt hatte, in die Klinik überwiesen. Die Ziege lag in Brustlage fest und konnte sich selbständig in den Hundshock erheben. Bei der neurologischen Untersuchung fielen als wichtigste Befunde eine verminderte Sensibilität der Hintergliedmassen auf Nadelstiche und ein beidseits verminderter Pannikulusreflex auf. Die Liquoruntersuchung ergab einen erhöhten Proteingehalt und einen erhöhten Leukozytengehalt. In der Differenzierung wurden 98 % Lymphozyten, 1 % Monozyten und 1 % neutrophile Granulozyten sowie 3 Mitosen gesehen. Aufgrund der klinischen Befunde wurde die Diagnose zentralnervöse Erkrankung mit Sitz im thorakolumbalen Bereich des Rückenmarks gestellt. Die Ziege wurde euthanasiert und pathologisch-anatomisch untersucht. Die Lymphknoten im Ileosakralbereich waren zu einer knotigen Masse von ca. 15 cm × 12 cm × 5 cm konfluiert, die auch die ventrale Wirbelsäule umschloss und in den Wirbelkanal eingedrungen war. Die histologische Untersuchung ergab ein kleinzelliges malignes Lymphom. Abstract: This report describes a 4-year-old goat with posterior paresis and subsequent paralysis caused by malignant lymphoma. The goat was referred to our clinic because of progressive posterior ataxia, which developed into posterior paresis and paralysis. The goat was presented in sternal recumbency but was able to assume a dog-sitting position. A neurological examination revealed reduced sensitivity to pricking of the skin with a needle, and a bilateral reduced panniculus reflex. The cerebrospinal fluid was slightly cloudy with increases in the protein concentration and leukocyte count, which consisted of 98 % lymphocytes, 1 % monocytes and 1 % neutrophils; three cells had mitotic figures. Based on the clinical findings, a tentative diagnosis of central nervous system disease of the thoracolumbar spinal cord was made, and euthanasia and postmortem examination were carried out. The lymph nodes in the ileosacral region appeared as a 15 × 12 × 5 cm confluent mass, which involved the ventral vertebral column and infiltrated the spinal canal. Histological examination of the tumour yielded a diagnosis of microcytic malignant lymphoma

Hämatologische und klinisch-chemische Referenzwerte für adulte Ziegen und Schafe

Sheep and goat husbandry has always played an important role in swiss agriculture, but in recent years these animals are increasingly appreciated as hobby pets. This opens new diagnostic and therapeutic perspectives for veterinary surgeons, notably in the determination of hematological and clinical biochemical parameters. For the current methods used there are no reference range values available for adult sheep and goats kept under swiss conditions. Therefore, the present study was designed to determine haematological and clinical biochemical parameters in 102 goats and 102 sheep from swiss flocks. Significant differences were found between the two species, especially regarding erythrocyte count, mean erythrocyte volume, hemoglobin content as well as leukocyte count. It is therefore of utmost importance to discriminate between sheep and goats when interpreting laboratory tween findings

Inguinal hernia repair in Switzerland

PURPOSE Inguinal hernia repair is one of the most common procedures in visceral surgery, and an important teaching operation for residents during their first years. A variety of surgical approaches is currently available, including open surgery with or without mesh and laparoscopic surgery. Here we assessed the current clinical practice for inguinal hernia surgery in Switzerland and the impact on training of surgical residents. METHODS An anonymous online survey was performed among surgical clinics of the Swiss Society of Visceral Surgery (SSVS). RESULTS The overall response rate was 51 %. Nearly all hernia repairs are performed with prosthetic material, and only 3.2 % of the procedures use no mesh. Overall, open surgery is used for 58.5 % of hernias and 41.5 % are operated laparoscopically. In laparoscopic surgery, TEP is the first choice. Overall, the Lichtenstein repair is the classical teaching operation performed by residents in 77.3 % of cases. In contrast to open surgery, laparoscopic hernia repair is not a training operation and residents perform only 9.7 % of laparoscopic hernia repairs. CONCLUSION The survey confirms the use of prosthetic material as the standard, and the Lichtenstein repair as the first choice for primary inguinal hernia repair. The popularity of laparoscopic hernia surgery is increasing at the price of less teaching operations available for young residents

Vorkommen von Gnitzen (Culicoides spp.) in drei Höhenlagen einer alpinen Region der Schweiz

The aim of this field study was to investigate the occurrence of biting midges (Culicoides spp.), the potential vectors of the bluetongue virus (BTV), in an alpine region of Switzerland (Vals/GR) at altitudes between 1300 and 2000 meters above sea level (m a.s.l.). For this purpose, insects were caught with UV-light traps once weekly from the end of June to the end of October 2008. Midges were found on all altitudes investigated, but distinct differences in the abundance at different stations were noticed. Most midges were caught at the intermediate station (about 1500 m a.s.l.) whereas the catches on the two alps (approximately 2000 m a.s.l.) varied considerably. The predominance of midges belonging to the Pulicaris complex, whose vector competence regarding bluetongue virus (BTV) is largely unknown, rose with increasing altitude. To identify potential breeding habitats, 17 soil samples of three farms were incubated in the laboratory. Different insects emerged but none of them was a Culicoides spp. and, therefore, the habitats of juvenile stages remain unknown. From our results we can conclude that most likely there are no midges-free zones in all of the agriculturally utilized areas (including the alpine summer pastures) of Switzerland. This strongly indicates that cattle, sheep, goats and camelids which are permanently or temporarily kept in regions of higher altitude in Switzerland should be vaccinated against bluetongu